Lake Forest Regenesis Medical Center, Pllc
NPI #1871308999 in Lake Forest, Illinois
Provider Information
- NPI Number
- 1871308999
- Entity Type
- Organization
- Organization Name
- Lake Forest Regenesis Medical Center, Pllc
- Primary Specialty
- Clinic/Center
- Enumeration Date
- Feb 7, 2025
- Last Updated
- Feb 7, 2025
Practice Location
- Address
- 1025 W EVERETT RD STE 2
- City
- Lake Forest
- State
- Illinois
- ZIP Code
- 60045-2668
- Phone
- (224) 436-8006
Authorized Official
- Name
- MRS. ALLANA KATHLEEN BUSH, FNP-C
- Title
- FNP-C
- Phone
- (224) 436-8006
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center |
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