Healthcare Provider Details

I. General information

NPI: 1285573311
Provider Name (Legal Business Name): LAURA OLIVAS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/25/2026
Last Update Date: 03/25/2026
Certification Date: 03/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3701 ALGONQUIN RD. SUITE 900
ROLLING MEADOWS IL
60008-3193
US

IV. Provider business mailing address

3701 ALGONQUIN RD. SUITE 900
ROLLING MEADOWS IL
60008-3193
US

V. Phone/Fax

Practice location:
  • Phone: 847-577-0620
  • Fax:
Mailing address:
  • Phone: 847-577-0620
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number209035083
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: