Provider Demographics
NPI:1164439253
Name:LAURA ROGERS ALLERGY & ASTHMA, M.D., S.C.
Entity Type:Organization
Organization Name:LAURA ROGERS ALLERGY & ASTHMA, M.D., S.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:
Authorized Official - Last Name:ROGERS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:312-867-7450
Mailing Address - Street 1:233 E ERIE ST STE 810
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-2906
Mailing Address - Country:US
Mailing Address - Phone:312-867-7450
Mailing Address - Fax:312-867-7455
Practice Address - Street 1:233 E ERIE ST STE 810
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-2906
Practice Address - Country:US
Practice Address - Phone:312-867-7450
Practice Address - Fax:312-867-7455
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-02
Last Update Date:2011-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-105222207KA0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207KA0200XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyAllergyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL=========Medicare UPIN
IL1634854Medicare ID - Type Unspecified