Healthcare Provider Details

I. General information

NPI: 1376465823
Provider Name (Legal Business Name): LAUREN THOMPSON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/27/2026
Last Update Date: 07/27/2026
Certification Date: 07/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1900 E MAIN ST
DANVILLE IL
61832-5100
US

IV. Provider business mailing address

502 S MAIN ST
GIFFORD IL
61847-9713
US

V. Phone/Fax

Practice location:
  • Phone: 217-554-3000
  • Fax:
Mailing address:
  • Phone: 269-340-4403
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number5302417790
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: