Provider Demographics
NPI:1033663174
Name:ZIGLER, LAURA PATRICIA (DO)
Entity Type:Individual
Prefix:DR
First Name:LAURA
Middle Name:PATRICIA
Last Name:ZIGLER
Suffix:
Gender:F
Credentials:DO
Other - Prefix:DR
Other - First Name:LAURA
Other - Middle Name:PATRICIA
Other - Last Name:STEARNS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:1430 COLLEGE DR STE B
Mailing Address - Street 2:
Mailing Address - City:MOUNT CARMEL
Mailing Address - State:IL
Mailing Address - Zip Code:62863-2649
Mailing Address - Country:US
Mailing Address - Phone:618-263-6190
Mailing Address - Fax:
Practice Address - Street 1:1430 COLLEGE DR STE B
Practice Address - Street 2:
Practice Address - City:MOUNT CARMEL
Practice Address - State:IL
Practice Address - Zip Code:62863-2649
Practice Address - Country:US
Practice Address - Phone:618-263-6190
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-05
Last Update Date:2021-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COTL0006052208600000X
MI5151012311390200000X
IL036.157874208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program