Individual
MRS. ELISE LAUDERDALE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ANP
Contact information
Practice address
5841 S MARYLAND AVE, CHICAGO, IL 60637-1447
(773) 702-1000
(773) 926-0852
Mailing address
5841 S MARYLAND AVE, CHICAGO, IL 60637-1447
(773) 702-1000
(773) 926-0852
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
209010248
IL
363LA2200X
Adult Health Nurse Practitioner
SP013050
PA
Other
Enumeration date
06/06/2014
Last updated
03/16/2017
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