1346496411 NPI number — MRS. LAUREN DONAGHER WATSON APN, CNP

Table of content: MRS. LAUREN DONAGHER WATSON APN, CNP (NPI 1346496411)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1346496411 NPI number — MRS. LAUREN DONAGHER WATSON APN, CNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
WATSON
Provider First Name:
LAUREN
Provider Middle Name:
DONAGHER
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
APN, CNP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
DONAGHER
Provider Other First Name:
LAUREN
Provider Other Middle Name:
MARIE
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
APN, CNP
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1346496411
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/16/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
110 E SCHILLER ST
Provider Second Line Business Mailing Address:
SUITE 318
Provider Business Mailing Address City Name:
ELMHURST
Provider Business Mailing Address State Name:
IL
Provider Business Mailing Address Postal Code:
60126
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
630-832-1775
Provider Business Mailing Address Fax Number:
630-832-3078

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
110 E SCHILLER ST
Provider Second Line Business Practice Location Address:
SUITE 318
Provider Business Practice Location Address City Name:
ELMHURST
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
60126
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
630-832-1775
Provider Business Practice Location Address Fax Number:
630-832-3078
Provider Enumeration Date:
08/08/2008

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LA2200X , with the licence number:  209006981 , registered in the state of IL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363LA2100X , with the licence number: 209.006981 , registered in the state of IL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)