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General NPI Number Information
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NPI Number | 1164439253
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Entity Type | Organization
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Legal Business Name | LAURA ROGERS ALLERGY & ASTHMA, M.D., S.C.
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Dates
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Enumeration Date | 08/02/2006
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Last Update Date | 02/17/2011
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Provider Practice Location Address
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Address Line | 233 E ERIE ST STE 810
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City | CHICAGO
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State | IL
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Zip | 60611-2906
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Country | US
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Telephone | 312-867-7450
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Fax | 312-867-7455
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Provider Business Mailing Address
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Address Line | 233 E ERIE ST STE 810
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City | CHICAGO
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State | IL
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Zip | 60611-2906
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Country | US
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Telephone | 312-867-7450
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Fax | 312-867-7455
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Authorized Official
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Title or Position | PRESIDENT
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Name | LAURA ROGERS
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Credential | M.D.
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Telephone | 312-867-7450
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207KA0200X
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Taxonomy Name | Allergy Physician
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License Number | 036-105222
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License Number State | IL
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