Provider Demographics
NPI:1245508522
Name:STONE, LORI K (CRNA)
Entity type:Individual
Prefix:
First Name:LORI
Middle Name:K
Last Name:STONE
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:680 N. LAKE SHORE DRIVE SUITE# 1000
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611
Mailing Address - Country:US
Mailing Address - Phone:312-695-0665
Mailing Address - Fax:
Practice Address - Street 1:215 E. HURON
Practice Address - Street 2:FEINBERG 5-704
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611
Practice Address - Country:US
Practice Address - Phone:312-695-0665
Practice Address - Fax:312-695-0050
Is Sole Proprietor?:No
Enumeration Date:2011-12-01
Last Update Date:2016-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209009272367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered