Healthcare Provider Details

I. General information

NPI: 1457762841
Provider Name (Legal Business Name): LAUREN MARIE ORF RN, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: LAUREN MARIE UNDERYS RN

II. Dates (important events)

Enumeration Date: 05/19/2014
Last Update Date: 06/06/2020
Certification Date: 06/06/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3100 W IL ROUTE 60
MUNDELEIN IL
60060-4267
US

IV. Provider business mailing address

3100 W IL ROUTE 60
MUNDELEIN IL
60060-4267
US

V. Phone/Fax

Practice location:
  • Phone: 847-409-6480
  • Fax:
Mailing address:
  • Phone: 847-409-6480
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN199185
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP8443
License Number StateAZ
# 3
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number2014006197
License Number StateMO
# 4
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number209.020956
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: