Deatrice Lavonna Black, LPN is a
Licensed Vocational Nurse based in Joliet, Illinois. Deatrice Lavonna Black is licensed to practice in Illinois (license number 043117036) and her current practice location is
503 Bellarmine Dr E Apt 7, Joliet, Illinois. She can be reached at her office (for appointments etc.) via phone at
(815) 456-9757.
NPI number for Deatrice Lavonna Black is 1215448352 and her current mailing address is 503 Bellarmine Dr E Apt 7, Joliet, Illinois. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1215448352.
Provider's Profile
Full Name | Deatrice Lavonna Black |
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Gender | Female |
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Speciality | Licensed Vocational Nurse |
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Location | 503 Bellarmine Dr E Apt 7, Joliet, Illinois |
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Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
NPI Data:
- NPI Number: 1215448352
- Provider Enumeration Date: 10/16/2017
- Last Update Date: 10/16/2017
Medical Identifiers
Medical identifiers for Deatrice Lavonna Black such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1215448352 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
164X00000X | Licensed Vocational Nurse | 043117036 (Illinois) | Primary |
164W00000X | Licensed Practical Nurse | 043117036 (Illinois) | Secondary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Deatrice Lavonna Black is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Deatrice Lavonna Black, LPN 503 Bellarmine Dr E Apt 7, Joliet, IL 60436-1838 Ph: (815) 456-9757 | Deatrice Lavonna Black, LPN 503 Bellarmine Dr E Apt 7, Joliet, IL 60436-1838 Ph: (815) 456-9757 |
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