Provider Demographics
NPI:1649768342
Name:SCHNACK, LAUREN LINDSAY (DPM, MS)
Entity Type:Individual
Prefix:DR
First Name:LAUREN
Middle Name:LINDSAY
Last Name:SCHNACK
Suffix:
Gender:F
Credentials:DPM, MS
Other - Prefix:DR
Other - First Name:LAUREN
Other - Middle Name:LINDSAY
Other - Last Name:SCHNACK
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LAUREN SCHNACK, DPM
Mailing Address - Street 1:3471 GREEN BAY ROAD
Mailing Address - Street 2:
Mailing Address - City:NORTH CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60064
Mailing Address - Country:US
Mailing Address - Phone:847-578-8442
Mailing Address - Fax:
Practice Address - Street 1:3471 GREEN BAY ROAD
Practice Address - Street 2:
Practice Address - City:NORTH CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60064
Practice Address - Country:US
Practice Address - Phone:847-578-8442
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-27
Last Update Date:2023-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH59.000711213ES0103X
IL016.005927213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH36.004031OtherSTATE MEDICAL BOARD OF OHIO
IL316.003115OtherSTATE OF ILLINOIS LICENSED PODIATRY CONTROLLED SUBSTANCE
IL016.005927OtherILLINOIS DEPARTMENT OF FINANCIAL AND PROFESSIONAL REGULATION