Individual
LAURA BERGQUIST
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CST/CSFA
Contact information
Practice address
4400 W 95TH ST STE 308, OAK LAWN, IL 60453-2660
(708) 346-4040
(708) 346-3287
Mailing address
4400 W 95TH ST STE 308, OAK LAWN, IL 60453-2660
(708) 346-4040
(708) 346-3287
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
—
—
Other
Enumeration date
02/06/2018
Last updated
02/06/2018
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