Provider Demographics
NPI:1063922425
Name:BENKOSKE, LAUREN MARIE (PHD)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:MARIE
Last Name:BENKOSKE
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:LAUREN
Other - Middle Name:MARIE
Other - Last Name:OSTARELLO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD
Mailing Address - Street 1:12936 FAIRMONT LN
Mailing Address - Street 2:
Mailing Address - City:LEMONT
Mailing Address - State:IL
Mailing Address - Zip Code:60439-8951
Mailing Address - Country:US
Mailing Address - Phone:630-337-8422
Mailing Address - Fax:
Practice Address - Street 1:12936 FAIRMONT LN
Practice Address - Street 2:
Practice Address - City:LEMONT
Practice Address - State:IL
Practice Address - Zip Code:60439-8951
Practice Address - Country:US
Practice Address - Phone:630-337-8422
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-10-11
Last Update Date:2023-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071.010730103TC0700X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical