Healthcare Provider Details

I. General information

NPI: 1871433474
Provider Name (Legal Business Name): TAMARA LABAN FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/31/2026
Last Update Date: 03/31/2026
Certification Date: 03/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

117 OAK BROOK RD
OAK BROOK IL
60523-2401
US

IV. Provider business mailing address

117 OAK BROOK RD
OAK BROOK IL
60523-2401
US

V. Phone/Fax

Practice location:
  • Phone: 331-299-0873
  • Fax:
Mailing address:
  • Phone: 331-299-0873
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number209034928
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: