Provider Demographics
NPI:1376034801
Name:LAMAS, AURA N
Entity Type:Individual
Prefix:
First Name:AURA
Middle Name:N
Last Name:LAMAS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2001 S CALIFORNIA AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60608-2486
Mailing Address - Country:US
Mailing Address - Phone:773-584-6200
Mailing Address - Fax:844-285-1003
Practice Address - Street 1:6550 S RICHMOND ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60629-2821
Practice Address - Country:US
Practice Address - Phone:773-584-6200
Practice Address - Fax:844-285-1003
Is Sole Proprietor?:No
Enumeration Date:2018-05-21
Last Update Date:2023-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXT2201208000000X
390200000X
IL036156927208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036156927Medicaid