Individual
LAUREN ELIZABETH AVIDANO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CAA
Contact information
Practice address
8701 BROADWAY, MERRILLVILLE, IN 46410-7035
(219) 738-5500
Mailing address
730 S CLARK ST APT 903, CHICAGO, IL 60605-1745
Taxonomy
Speciality
Code
Description
License number
State
367H00000X
Anesthesiologist Assistant
Primary
75000210A
IN
Other
Enumeration date
03/10/2025
Last updated
03/10/2025
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