Provider Demographics
NPI:1043564065
Name:MAKEEVER, LAURA (NP)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:MAKEEVER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:693 SNOW CAP CT
Mailing Address - Street 2:
Mailing Address - City:GURNEE
Mailing Address - State:IL
Mailing Address - Zip Code:60031-5659
Mailing Address - Country:US
Mailing Address - Phone:847-254-0471
Mailing Address - Fax:
Practice Address - Street 1:2100 SANDERS RD
Practice Address - Street 2:SUITE 100
Practice Address - City:NORTHBROOK
Practice Address - State:IL
Practice Address - Zip Code:60062-6139
Practice Address - Country:US
Practice Address - Phone:847-272-7338
Practice Address - Fax:847-272-7380
Is Sole Proprietor?:No
Enumeration Date:2012-10-29
Last Update Date:2014-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209-008490363LA2200X
IL041.306611163WI0500X, 163WX0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No163WI0500XNursing Service ProvidersRegistered NurseInfusion Therapy
No163WX0200XNursing Service ProvidersRegistered NurseOncology