Provider Demographics
NPI:1588951594
Name:SHIELDS, LAUREN JEAN (APN)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:JEAN
Last Name:SHIELDS
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 S MICHIGAN AVE
Mailing Address - Street 2:6TH FLOOR
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60603-3200
Mailing Address - Country:US
Mailing Address - Phone:312-592-6800
Mailing Address - Fax:312-592-6801
Practice Address - Street 1:18 S MICHIGAN AVE
Practice Address - Street 2:6TH FLOOR
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60603-3200
Practice Address - Country:US
Practice Address - Phone:312-592-6800
Practice Address - Fax:312-592-6801
Is Sole Proprietor?:No
Enumeration Date:2011-06-29
Last Update Date:2011-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209.008573363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL041.346848Medicaid