Healthcare Provider Details

I. General information

NPI: 1437802329
Provider Name (Legal Business Name): LAUREN ASHLEY MCDONEL DC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/31/2022
Last Update Date: 01/31/2022
Certification Date: 01/31/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1408 S MAIN ST
ALGONQUIN IL
60102-2746
US

IV. Provider business mailing address

10498 GREAT PLAINES DR
HUNTLEY IL
60142-6616
US

V. Phone/Fax

Practice location:
  • Phone: 847-854-0829
  • Fax:
Mailing address:
  • Phone: 224-688-7165
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number038.031842
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: