Ambrose, Laureen L
Ambrose, Laureen L is an sole proprietor health care provider with primary practice located at 15300 West Ave Suite 205, Orland Park IL 60462-4600. She recently has only one registered license in Other Service Providers / Specialist, which is considered as her primary health care specialty. Ambrose, Laureen L can be contacted via phone (708) 460-1040.Contact Information
Primary practice address
15300 West Ave Suite 205
Orland Park IL 60462-4600
Phone: (708) 460-1040
Fax: (708) 460-6872
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Specialist | 174400000X | 036-059550 | Illinois |
Profile Details
| NPI number | 1710902077 |
|---|---|
| LBN Legal business name | Ambrose, Laureen L |
| Credentials | MD SC |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jul 13th, 2006 |
| Last updated | Apr 1st, 2011 - about 13 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1710902077 | NPPES |
| Illinois | Other | 31600367 | BLUE CROSS BLUE SHIELD |
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