Provider Demographics
NPI:1437501624
Name:FLOYD, LAUREN (LD, LDN)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:
Last Name:FLOYD
Suffix:
Gender:F
Credentials:LD, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5300 OLD ORCHARD RD
Mailing Address - Street 2:
Mailing Address - City:SKOKIE
Mailing Address - State:IL
Mailing Address - Zip Code:60077-1028
Mailing Address - Country:US
Mailing Address - Phone:847-470-8600
Mailing Address - Fax:
Practice Address - Street 1:5300 OLD ORCHARD RD
Practice Address - Street 2:
Practice Address - City:SKOKIE
Practice Address - State:IL
Practice Address - Zip Code:60077-1028
Practice Address - Country:US
Practice Address - Phone:847-470-8600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-12
Last Update Date:2016-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL164005003133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered