Provider Demographics
NPI:1659652196
Name:WILLS, LAUREN NATALIE (DC)
Entity Type:Individual
Prefix:DR
First Name:LAUREN
Middle Name:NATALIE
Last Name:WILLS
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1710 E 1ST ST
Mailing Address - Street 2:
Mailing Address - City:STERLING
Mailing Address - State:IL
Mailing Address - Zip Code:61081-2902
Mailing Address - Country:US
Mailing Address - Phone:815-875-7917
Mailing Address - Fax:
Practice Address - Street 1:1710 E 1ST ST
Practice Address - Street 2:
Practice Address - City:STERLING
Practice Address - State:IL
Practice Address - Zip Code:61081-2902
Practice Address - Country:US
Practice Address - Phone:815-875-7917
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-29
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038013101111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NS0005XChiropractic ProvidersChiropractorSports PhysicianGroup - Single Specialty