Individual
MRS. LAUREN ELIZABETH GARDSTROM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN
Contact information
Practice address
2656 N ELSTON AVE, CHICAGO, IL 60647-2019
(773) 252-1994
Mailing address
2333 W SAINT PAUL AVE, APT 212, CHICAGO, IL 60647-5388
(219) 688-2970
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
209009248
IL
363LF0000X
Family Nurse Practitioner
Primary
209009248
IL
Other
Enumeration date
12/05/2011
Last updated
11/17/2015
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