Healthcare Provider Details

I. General information

NPI: 1831546340
Provider Name (Legal Business Name): LAURA J. JORGENSEN APN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/16/2016
Last Update Date: 07/29/2026
Certification Date: 07/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1855 W IRVING PARK RD
SCHAUMBURG IL
60193-3516
US

IV. Provider business mailing address

1855 W IRVING PARK RD
SCHAUMBURG IL
60193-3516
US

V. Phone/Fax

Practice location:
  • Phone: 866-389-8272
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number209013937
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: