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General NPI Number Information
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NPI Number | 1285100529
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Entity Type | Individual
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Provider Name | LAUREN E LESNIEWSKI PA-C
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Gender | Female
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Dates
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Enumeration Date | 10/14/2018
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Last Update Date | 02/21/2020
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Provider Practice Location Address
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Address Line | 680 N LAKE SHORE DR STE 1210
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City | CHICAGO
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State | IL
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Zip | 60611-4490
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Country | US
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Telephone | 312-587-3765
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Fax |
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Provider Business Mailing Address
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Address Line | 676 N LASALLE DR APT 708
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City | CHICAGO
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State | IL
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Zip | 60654
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Country | US
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Telephone | 585-545-5214
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | OA004637
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | OA004637
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License Number State | PA
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