Individual
LAUREN ELIZABETH DICICCO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MMS, PA-C
Contact information
Practice address
251 E HURON ST, SUITE 16-738, CHICAGO, IL 60611-2908
(312) 503-1851
Mailing address
251 E HURON ST, SUITE 16-738, CHICAGO, IL 60611-2908
(312) 503-1851
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
—
—
Other
Enumeration date
04/08/2015
Last updated
02/20/2024
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