Provider Demographics
NPI:1902637010
Name:ROBERTS, LORIANNE BETH (DNP)
Entity type:Individual
Prefix:DR
First Name:LORIANNE
Middle Name:BETH
Last Name:ROBERTS
Suffix:
Gender:F
Credentials:DNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3844 N ASHLAND AVE UNIT 23
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60613-5947
Mailing Address - Country:US
Mailing Address - Phone:970-581-6128
Mailing Address - Fax:
Practice Address - Street 1:3212 N LINCOLN AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60657-1106
Practice Address - Country:US
Practice Address - Phone:773-347-2677
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-10
Last Update Date:2024-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209029647363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner