Healthcare Provider Details

I. General information

NPI: 1700822590
Provider Name (Legal Business Name): LAUREN SAXE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/21/2006
Last Update Date: 07/12/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18440 GOVERNORS HWY
HOMEWOOD IL
60430-2911
US

IV. Provider business mailing address

18440 GOVERNORS HWY
HOMEWOOD IL
60430-2911
US

V. Phone/Fax

Practice location:
  • Phone: 708-798-2191
  • Fax: 708-798-2317
Mailing address:
  • Phone: 708-798-2191
  • Fax: 708-798-2317

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number036079170
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: