Provider Demographics
NPI:1366689754
Name:LANING, GWEN LYNN (RN)
Entity type:Individual
Prefix:MRS
First Name:GWEN
Middle Name:LYNN
Last Name:LANING
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2S750 AVENUE CHERBOURG
Mailing Address - Street 2:
Mailing Address - City:OAK BROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60523-1008
Mailing Address - Country:US
Mailing Address - Phone:630-544-4733
Mailing Address - Fax:
Practice Address - Street 1:2S750 AVENUE CHERBOURG
Practice Address - Street 2:
Practice Address - City:OAK BROOK
Practice Address - State:IL
Practice Address - Zip Code:60523-1008
Practice Address - Country:US
Practice Address - Phone:630-544-4733
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-07
Last Update Date:2009-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL041153438163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health