MEDICARE: LAURA ROGERS ALLERGY & ASTHMA, M.D., S.C.

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	207KA0200X	Allergy Physician	036-105222	IL

General Provider Information

NPI Number	:	1164439253
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LAURA ROGERS ALLERGY & ASTHMA, M.D., S.C.

Provider Business Mailing Address
First Line	:	233 E ERIE ST STE 810
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60611-2906
Country	:	US
Telephone Number	:	312-867-7450
Fax Number	:	312-867-7455

Provider Business Practice Location Address
First Line	:	233 E ERIE ST STE 810
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60611-2906
Country	:	US
Telephone Number	:	312-867-7450
Fax Number	:	312-867-7455

Authorized Official
Title or Position	:	PRESIDENT
Name	:	LAURA ROGERS
Credential	:	M.D.
Telephone Number	:	312-867-7450

Provider Enumeration Date	:	08/02/2006
Last Update Date	:	02/17/2011

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