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Organization

LAURA VAN DUSEN M.D. S.C.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
LAURA VAN DUSEN VAN DUSEN M.D. (PRESIDENT)
(847) 296-3442
Entity
Organization

Contact information

Practice address
1440 RENAISSANCE DR, SUITE 200, PARK RIDGE, IL 60068-1356
(847) 296-3442
(847) 296-3543
Mailing address
1440 RENAISSANCE DR, SUITE 200, PARK RIDGE, IL 60068-1356
(847) 296-3442
(847) 296-3543

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
036103137
IL

Other

Enumeration date
10/09/2006
Last updated
11/07/2010
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