Provider Demographics
NPI:1306619945
Name:HEITMAN, LAUREN CHRISTINE (APRN)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:CHRISTINE
Last Name:HEITMAN
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1512 N SEDGWICK ST APT 2
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60610-8735
Mailing Address - Country:US
Mailing Address - Phone:317-691-9444
Mailing Address - Fax:
Practice Address - Street 1:737 N MICHIGAN AVE STE 600
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-6662
Practice Address - Country:US
Practice Address - Phone:312-440-3810
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-06
Last Update Date:2023-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209.028688363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner