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Individual

MRS. LAUREN E WELTON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
11362 COUNTRY CLUB ROAD, LAWRENCEVILLE, IL 62439
(618) 943-3302
(618) 943-7589
Mailing address
PO BOX 516, LAWRENCEVILLE, IL 62439
(618) 943-3302
(918) 943-7589

Taxonomy

Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
376006178
IL
Enumeration date
09/06/2019
Last updated
09/06/2019
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