# LAURA ELIZABETH BLACK

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1538504881
- **Gender:** F
- **Credential:** M.D.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208100000X | Physical Medicine & Rehabilitation Physician | 125062536 | IL | — |
| 2081P0010X | Pediatric Rehabilitation Medicine Physician | 01081976A | IN | Yes |
| 2081P0010X | Pediatric Rehabilitation Medicine Physician | D0095134 | MD | — |

## Other

- **Enumeration date:** 04/30/2013
- **Last updated:** 02/10/2023