Provider Demographics
NPI:1134677255
Name:LAUREN LUND PSYCHOLOGICAL SERVICES
Entity Type:Organization
Organization Name:LAUREN LUND PSYCHOLOGICAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:LAUREN
Authorized Official - Middle Name:
Authorized Official - Last Name:MCARDLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:773-339-3944
Mailing Address - Street 1:795 INTERLAKEN DR
Mailing Address - Street 2:
Mailing Address - City:LAKE ZURICH
Mailing Address - State:IL
Mailing Address - Zip Code:60047-1335
Mailing Address - Country:US
Mailing Address - Phone:773-339-3944
Mailing Address - Fax:
Practice Address - Street 1:800 E NORTHWEST HWY
Practice Address - Street 2:SUITE 303
Practice Address - City:PALATINE
Practice Address - State:IL
Practice Address - Zip Code:60074-6519
Practice Address - Country:US
Practice Address - Phone:773-339-3944
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-18
Last Update Date:2016-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071008758305R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization