Provider Demographics
NPI:1093591844
Name:CANFIELD, LAUREN (EDS)
Entity Type:Individual
Prefix:MRS
First Name:LAUREN
Middle Name:
Last Name:CANFIELD
Suffix:
Gender:F
Credentials:EDS
Other - Prefix:MISS
Other - First Name:LAUREN
Other - Middle Name:
Other - Last Name:SLAUGHTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:EDS
Mailing Address - Street 1:100 N PROSPECT AVE
Mailing Address - Street 2:
Mailing Address - City:CLARENDON HILLS
Mailing Address - State:IL
Mailing Address - Zip Code:60514-1230
Mailing Address - Country:US
Mailing Address - Phone:630-861-4400
Mailing Address - Fax:
Practice Address - Street 1:100 N PROSPECT AVE
Practice Address - Street 2:
Practice Address - City:CLARENDON HILLS
Practice Address - State:IL
Practice Address - Zip Code:60514-1230
Practice Address - Country:US
Practice Address - Phone:630-861-4400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-07
Last Update Date:2023-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL924877103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool