Individual
LAUREN ELLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
11600 S KEDZIE AVE, MERRIONETTE PARK, IL 60803-6307
(708) 272-4150
Mailing address
521 W BRIAR PL APT 304, CHICAGO, IL 60657-4654
(248) 943-1274
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
209020853
IL
Other
Enumeration date
03/05/2020
Last updated
03/05/2020
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