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NPI Code Detail

MEDICARE: LAURA N. ENDRES FNP-C

MEDICARE: LAURA N. ENDRES FNP-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
1363LF0000XFamily Nurse PractitionerA169585IA

General Provider Information

NPI Number : 1346616976
Entity Type Code : Individual
Provider Name (Legal Business Name) : LAURA N. ENDRES FNP-C
Provider Business Mailing Address
First Line : 6348 N MILWAUKEE AVE STE 390
Second Line :
City : CHICAGO
State : IL
Zip : 60646-3728
Country : US
Telephone Number : 847-235-6130
Fax Number : 847-235-6135
Provider Business Practice Location Address
First Line : 1130 W 53RD ST
Second Line :
City : DAVENPORT
State : IA
Zip : 52806-2401
Country : US
Telephone Number : 847-235-6130
Fax Number : 847-235-6135
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/18/2015
Last Update Date : 12/08/2025

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Directions to “ LAURA N. ENDRES FNP-C” Practice Location

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