Provider Demographics
NPI:1699049817
Name:KOVEL, LYNN ROBIN (RN, BSN)
Entity type:Individual
Prefix:
First Name:LYNN
Middle Name:ROBIN
Last Name:KOVEL
Suffix:
Gender:F
Credentials:RN, BSN
Other - Prefix:
Other - First Name:LYNN
Other - Middle Name:KOVEL
Other - Last Name:PFEIFER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RN, BSN
Mailing Address - Street 1:3010 GRAND AVE FL 1
Mailing Address - Street 2:
Mailing Address - City:WAUKEGAN
Mailing Address - State:IL
Mailing Address - Zip Code:60085-2321
Mailing Address - Country:US
Mailing Address - Phone:847-377-8950
Mailing Address - Fax:847-984-5602
Practice Address - Street 1:3010 GRAND AVE FL 1
Practice Address - Street 2:
Practice Address - City:WAUKEGAN
Practice Address - State:IL
Practice Address - Zip Code:60085-2321
Practice Address - Country:US
Practice Address - Phone:847-377-8950
Practice Address - Fax:847-984-5602
Is Sole Proprietor?:No
Enumeration Date:2012-03-06
Last Update Date:2012-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL041244438163WP0807X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0807XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Child & Adolescent