Provider Demographics
NPI:1487286548
Name:KRACINSKI, LISA KAY (APN)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:KAY
Last Name:KRACINSKI
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10745 S HAMLIN AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60655-3914
Mailing Address - Country:US
Mailing Address - Phone:773-332-7343
Mailing Address - Fax:
Practice Address - Street 1:340 W BUTTERFIELD RD STE 3B
Practice Address - Street 2:
Practice Address - City:ELMHURST
Practice Address - State:IL
Practice Address - Zip Code:60126-5043
Practice Address - Country:US
Practice Address - Phone:630-869-0888
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-06
Last Update Date:2025-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209020605363L00000X, 363LF0000X
IL209.020605363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner