Provider Demographics
NPI:1710503735
Name:LYUTA, IRYNA (DNP, APRN, FNP-BC)
Entity type:Individual
Prefix:
First Name:IRYNA
Middle Name:
Last Name:LYUTA
Suffix:
Gender:F
Credentials:DNP, APRN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7301 W 25TH ST STE 252
Mailing Address - Street 2:
Mailing Address - City:NORTH RIVERSIDE
Mailing Address - State:IL
Mailing Address - Zip Code:60546-1409
Mailing Address - Country:US
Mailing Address - Phone:773-425-8778
Mailing Address - Fax:601-429-9342
Practice Address - Street 1:7301 W 25TH ST STE 252
Practice Address - Street 2:
Practice Address - City:NORTH RIVERSIDE
Practice Address - State:IL
Practice Address - Zip Code:60546-1409
Practice Address - Country:US
Practice Address - Phone:773-425-8778
Practice Address - Fax:601-429-9342
Is Sole Proprietor?:No
Enumeration Date:2020-06-25
Last Update Date:2024-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL277003322363LF0000X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health