Nicole Lasak, RN

Primary specialty

Administrator Registered NurseTaxonomy code 163WA2000X

License

041404276 Issued in IL

Practice address

3002 Grand Ave
Waukegan, IL 60085-2321

Phone

(847) 377-8278

NPI assigned

Aug 30, 2017

Last updated

Aug 30, 2017By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1504051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1504051200000",
    "number": "1881112712",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "841 MOCKING BIRD DR",
            "city": "ANTIOCH",
            "state": "IL",
            "postal_code": "600022726",
            "telephone_number": "847-377-8278",
            "fax_number": "847-984-5676"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3002 GRAND AVE",
            "city": "WAUKEGAN",
            "state": "IL",
            "postal_code": "600852321",
            "telephone_number": "847-377-8278"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LASAK",
        "first_name": "NICOLE",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-30",
        "last_updated": "2017-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WA2000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Administrator",
            "state": "IL",
            "license": "041404276",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alfonso R Lara
• Gabriela Lara
• Gloria Lara
• Elissa Marie Larkin, APN, CNM
• Ashlyn Larson
• Suriyya Azra Maryum Latif
• Laureate Terrace Operations LLC
• Erika Lavin
• Jean Lawrence, FNP
• Natalie Lawrence

• Administrator Registered Nurse in Waukegan, IL
• Providers in Waukegan, IL by specialty
• Administrator Registered Nurse in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.