MISS TAKALA B FOMOND LPN NPI 1215685565

NPI Information

  • NPI: 1215685565
  • Provider Name: MISS TAKALA B FOMOND, LPN
  • Classification: Licensed Practical Nurse - 164W00000X
  • Entity Type: Individual
  • Address: 2916 CENTRAL ST # 2
    EVANSTON, IL
    ZIP 60201
  • Phone: (224) 420-6894

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NPI Details

MISS Takala B Fomond, LPN is a licensed practical nurse in Evanston, IL. The provider is a licensed practical nurse with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states. MISS Takala B Fomond, LPN NPI is 1215685565. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

2916 CENTRAL ST # 2
EVANSTON, IL
ZIP 60201-212
Phone: (224) 420-6894

The enumeration date for this NPI number is 3/15/2022 and was last updated on 11/2/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1164W00000XLicensed Practical Nurse043.117753ILLINOISYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

NPI Synchronization or Removal

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