MEDICARE: LAURA MAKEEVER NP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LA2200X	Adult Health Nurse Practitioner	209-008490	IL

General Provider Information

NPI Number	:	1043564065
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAURA MAKEEVER NP

Provider Business Mailing Address
First Line	:	693 SNOW CAP CT
Second Line	:
City	:	GURNEE
State	:	IL
Zip	:	60031-5659
Country	:	US
Telephone Number	:	847-254-0471
Fax Number	:

Provider Business Practice Location Address
First Line	:	2100 SANDERS RD
Second Line	:	SUITE 100
City	:	NORTHBROOK
State	:	IL
Zip	:	60062-6139
Country	:	US
Telephone Number	:	847-272-7338
Fax Number	:	847-272-7380

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/29/2012
Last Update Date	:	11/18/2014

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