Provider Demographics
NPI:1194174672
Name:WHEELER, LAUREN ROSE
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:ROSE
Last Name:WHEELER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1810 W LOCUST LN
Mailing Address - Street 2:
Mailing Address - City:MOUNT PROSPECT
Mailing Address - State:IL
Mailing Address - Zip Code:60056-4406
Mailing Address - Country:US
Mailing Address - Phone:847-946-7492
Mailing Address - Fax:
Practice Address - Street 1:1810 W LOCUST LN
Practice Address - Street 2:
Practice Address - City:MOUNT PROSPECT
Practice Address - State:IL
Practice Address - Zip Code:60056-4406
Practice Address - Country:US
Practice Address - Phone:847-946-7492
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-06
Last Update Date:2016-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist