Provider Demographics
NPI:1568934941
Name:SABAS, LAURIE (NP)
Entity Type:Individual
Prefix:
First Name:LAURIE
Middle Name:
Last Name:SABAS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:LAURIE
Other - Middle Name:
Other - Last Name:ROTH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1000 REMINGTON BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:BOLINGBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60440-4707
Mailing Address - Country:US
Mailing Address - Phone:224-273-3381
Mailing Address - Fax:
Practice Address - Street 1:7447 W TALCOTT AVE STE 327
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60631-3719
Practice Address - Country:US
Practice Address - Phone:773-990-6440
Practice Address - Fax:773-990-6449
Is Sole Proprietor?:No
Enumeration Date:2018-12-21
Last Update Date:2019-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209018552363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner