Provider Demographics
NPI:1427825629
Name:PEARSON LASLEY AND ASSOCIATES
Entity type:Organization
Organization Name:PEARSON LASLEY AND ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NP/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JAWAN
Authorized Official - Middle Name:
Authorized Official - Last Name:LASLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:312-479-3038
Mailing Address - Street 1:2600 S MICHIGAN AVE
Mailing Address - Street 2:STE LLD
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60616
Mailing Address - Country:US
Mailing Address - Phone:312-479-3038
Mailing Address - Fax:
Practice Address - Street 1:2600 S MICHIGAN AVE
Practice Address - Street 2:STE LLD
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60616
Practice Address - Country:US
Practice Address - Phone:312-479-3038
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-07
Last Update Date:2023-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty