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NPI Code Detail

MEDICARE: LAUREN PORTER PHARMD

MEDICARE: LAUREN PORTER PHARMD
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
11835P1300XPsychiatric Pharmacist26028265AIN

General Provider Information

NPI Number : 1548884869
Entity Type Code : Individual
Provider Name (Legal Business Name) : LAUREN PORTER PHARMD
Provider Business Mailing Address
First Line : 3001 GREEN BAY RD
Second Line :
City : NORTH CHICAGO
State : IL
Zip : 60064-3048
Country : US
Telephone Number : 224-610-5996
Fax Number :
Provider Business Practice Location Address
First Line : 3001 GREEN BAY RD
Second Line :
City : NORTH CHICAGO
State : IL
Zip : 60064-3048
Country : US
Telephone Number : 224-610-5996
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/02/2020
Last Update Date : 01/07/2026

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