Provider Demographics
NPI:1962873075
Name:HILB, LAURA E (ARNP)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:E
Last Name:HILB
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2121 DEWEY AVE
Mailing Address - Street 2:
Mailing Address - City:EVANSTON
Mailing Address - State:IL
Mailing Address - Zip Code:60201-3057
Mailing Address - Country:US
Mailing Address - Phone:813-743-8471
Mailing Address - Fax:
Practice Address - Street 1:2121 DEWEY AVE
Practice Address - Street 2:
Practice Address - City:EVANSTON
Practice Address - State:IL
Practice Address - Zip Code:60201-3057
Practice Address - Country:US
Practice Address - Phone:224-307-9994
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-10-14
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9417731363LF0000X
IL209015002363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLP01596091OtherRR MCR
FL016225600Medicaid
FL016225600Medicaid