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NPI Code Detail

MEDICARE: MISS LAUREN J GRANDERSON

MEDICARE:  MISS LAUREN J GRANDERSON
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1336084821
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISS LAUREN J GRANDERSON
Provider Business Mailing Address
First Line : 2740 CHAYES CT APT E
Second Line :
City : HOMEWOOD
State : IL
Zip : 60430-2942
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2755 CHURCH RD
Second Line :
City : AURORA
State : IL
Zip : 60502-9745
Country : US
Telephone Number : 630-486-3800
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/21/2026
Last Update Date : 04/21/2026

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Directions to “ MISS LAUREN J GRANDERSON ” Practice Location

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