Provider Demographics
NPI:1174657746
Name:LYONS, RACHEL L (APNP, FNP)
Entity type:Individual
Prefix:MS
First Name:RACHEL
Middle Name:L
Last Name:LYONS
Suffix:
Gender:F
Credentials:APNP, FNP
Other - Prefix:MS
Other - First Name:RACHEL
Other - Middle Name:L
Other - Last Name:LUTY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APNP, FNP
Mailing Address - Street 1:2650 RIDGE AVE STE 1223
Mailing Address - Street 2:
Mailing Address - City:EVANSTON
Mailing Address - State:IL
Mailing Address - Zip Code:60201-1700
Mailing Address - Country:US
Mailing Address - Phone:847-982-3362
Mailing Address - Fax:
Practice Address - Street 1:9977 WOODS DR STE 100
Practice Address - Street 2:
Practice Address - City:SKOKIE
Practice Address - State:IL
Practice Address - Zip Code:60077-1057
Practice Address - Country:US
Practice Address - Phone:224-364-2273
Practice Address - Fax:847-663-2374
Is Sole Proprietor?:No
Enumeration Date:2007-03-15
Last Update Date:2025-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3064363L00000X, 363LF0000X
IL277-002065363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI36027300Medicaid
3006005233-22OtherFNP CERTIFICATION NUMBER
WIQ76132Medicare UPIN
WI36027300Medicaid