Basic Information
| Provider Information | |||||||||
| NPI: | 1265771349 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GOERING | ||||||||
| FirstName: | LADAWNA | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | ANP ANP-BC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 172 SCHILLER ST | ||||||||
| Address2: | |||||||||
| City: | ELMHURST | ||||||||
| State: | IL | ||||||||
| PostalCode: | 601262885 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3312216377 | ||||||||
| FaxNumber: | 3312212706 | ||||||||
| Practice Location | |||||||||
| Address1: | 133 E BRUSH HILL | ||||||||
| Address2: | SUITE 310 | ||||||||
| City: | ELMHURST | ||||||||
| State: | IL | ||||||||
| PostalCode: | 60126 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3312219003 | ||||||||
| FaxNumber: | 3312213978 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/08/2013 | ||||||||
| LastUpdateDate: | 08/15/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363L00000X | 209.009978 | IL | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
No ID Information.