Vickie Lindstrom, RN

Individual provider Active NPI Administrator Registered Nurse · McLeansboro, IL

NPI 1891381679 · NPPES record last updated May 22, 2025

Key facts

NPI
1891381679
Entity type
Individual (NPI type 1)
Primary specialty
Administrator Registered Nurse 163WA2000X
License
041416282 (IL)
Practice address
206 S Washington Street
McLeansboro, IL 62859
Phone
(618) 643-2835
Fax
(618) 643-2891
NPI assigned
Dec 16, 2020
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN163493AZMDRegistered Nurse
041416282ILMDAdministrator Registered Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN163493 AZ
School Registered Nurse 163WS0200X RN163493 AZ
Administrator Registered Nurse 163WA2000X 041416282 IL Yes

Addresses

Primary practice location

206 S Washington Street
McLeansboro, IL 62859

Mailing address

206 S Washington Street
McLeansboro, IL 62859
Phone (618) 643-2835

Other providers in McLeansboro, IL

All providers in McLeansboro, IL · Administrator Registered Nurse in Illinois

Sources for this page

Verify at the official NPI Registry.