Individual
LAUREN HARRIETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
115 N PARKSIDE AVE, CHICAGO, IL 60644-3040
(773) 295-3060
(773) 295-3061
Mailing address
14 LAKE ST, OAK PARK, IL 60302-2606
(708) 383-0113
(773) 836-7381
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036148337
IL
390200000X
Student in an Organized Health Care Education/Training Program
H63052587921
IL
Other
Enumeration date
05/09/2016
Last updated
03/14/2024
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