Provider Demographics
NPI:1215141775
Name:LAWRENCE, PATRICIA B (NP)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:B
Last Name:LAWRENCE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4709 GOLF RD STE 900
Mailing Address - Street 2:
Mailing Address - City:SKOKIE
Mailing Address - State:IL
Mailing Address - Zip Code:60076-1244
Mailing Address - Country:US
Mailing Address - Phone:847-676-5394
Mailing Address - Fax:847-679-7183
Practice Address - Street 1:4709 GOLF RD STE 900
Practice Address - Street 2:
Practice Address - City:SKOKIE
Practice Address - State:IL
Practice Address - Zip Code:60076
Practice Address - Country:US
Practice Address - Phone:847-676-5394
Practice Address - Fax:847-679-7183
Is Sole Proprietor?:No
Enumeration Date:2007-05-10
Last Update Date:2021-04-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL209-000204363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL209-000204OtherIL STATE LIC