Healthcare Provider Details

I. General information

NPI: 1225904295
Provider Name (Legal Business Name): LAUREN SHEEHAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/15/2025
Last Update Date: 10/15/2025
Certification Date: 10/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1740 W TAYLOR ST STE 3200W
CHICAGO IL
60612-7232
US

IV. Provider business mailing address

430 GREENLEAF CT
WESTMONT IL
60559-3512
US

V. Phone/Fax

Practice location:
  • Phone: 312-996-4020
  • Fax:
Mailing address:
  • Phone: 630-235-0553
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number209.033554
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: