Provider Demographics
NPI:1407896020
Name:KAUFFMAN, LAURA ANN (MD)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:ANN
Last Name:KAUFFMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:LAURA
Other - Middle Name:ANN
Other - Last Name:WEINGART
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1431 N WESTERN AVE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60622-1797
Mailing Address - Country:US
Mailing Address - Phone:773-276-2272
Mailing Address - Fax:773-276-2399
Practice Address - Street 1:1431 N WESTERN AVE
Practice Address - Street 2:SUITE 101
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60622-1797
Practice Address - Country:US
Practice Address - Phone:773-276-2272
Practice Address - Fax:773-276-2399
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-08
Last Update Date:2012-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-115307208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics