Basic Information
| Provider Information | |||||||||
| NPI: | 1851630800 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | NELSON | ||||||||
| FirstName: | LAUREN | ||||||||
| MiddleName: | ELIZABETH | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | D.C. | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | GATLIN | ||||||||
| OtherFirstName: | LAUREN | ||||||||
| OtherMiddleName: | ELIZABETH | ||||||||
| OtherNamePrefix: | MS. | ||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | BEHAVIOR ANALYST | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 3000 WOODCREEK DR | ||||||||
| Address2: | SUITE 120 | ||||||||
| City: | DOWNERS GROVE | ||||||||
| State: | IL | ||||||||
| PostalCode: | 605155401 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6305193239 | ||||||||
| FaxNumber: | 8169848281 | ||||||||
| Practice Location | |||||||||
| Address1: | 3000 WOODCREEK DR | ||||||||
| Address2: | SUITE 120 | ||||||||
| City: | DOWNERS GROVE | ||||||||
| State: | IL | ||||||||
| PostalCode: | 605155401 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6305193239 | ||||||||
| FaxNumber: | 8169848281 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/12/2013 | ||||||||
| LastUpdateDate: | 06/04/2014 | ||||||||
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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 | 111N00000X | 038012624 | IL | Y | Chiropractic Providers | Chiropractor |
No ID Information.