Healthcare Provider Details

I. General information

NPI: 1184199531
Provider Name (Legal Business Name): LAUREN ASHLEY SABBATH FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LAUREN HUSS RN

II. Dates (important events)

Enumeration Date: 10/11/2018
Last Update Date: 04/17/2025
Certification Date: 04/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6201 W HOWARD ST STE 211A
NILES IL
60714-3435
US

IV. Provider business mailing address

1145 VAN BUREN AVE
DES PLAINES IL
60018-1558
US

V. Phone/Fax

Practice location:
  • Phone: 708-428-2996
  • Fax:
Mailing address:
  • Phone: 217-390-5601
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WC0400X
TaxonomyCase Management Registered Nurse
License Number041409897
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number277002653
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: