MEDICARE: LAUREN MING

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	122300000X	Dentist	019031245	IL

General Provider Information

NPI Number	:	1356876635
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAUREN MING

Provider Business Mailing Address
First Line	:	2550 W ADDISON ST
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60618-5952
Country	:	US
Telephone Number	:	773-423-6050
Fax Number	:

Provider Business Practice Location Address
First Line	:	6307 S STEWART AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60621-3116
Country	:	US
Telephone Number	:	773-962-3976
Fax Number	:

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

Provider Enumeration Date	:	04/25/2017
Last Update Date	:	06/04/2026

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Directions to “ LAUREN MING ” Practice Location

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