Provider Demographics
NPI:1689298424
Name:LIGOCKI, LAURYN NICOLE (DDS)
Entity Type:Individual
Prefix:
First Name:LAURYN
Middle Name:NICOLE
Last Name:LIGOCKI
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1S224 SUMMIT AVE STE 104
Mailing Address - Street 2:
Mailing Address - City:OAKBROOK TERRACE
Mailing Address - State:IL
Mailing Address - Zip Code:60181-3938
Mailing Address - Country:US
Mailing Address - Phone:630-620-8099
Mailing Address - Fax:
Practice Address - Street 1:1S224 SUMMIT AVE STE 104
Practice Address - Street 2:
Practice Address - City:OAKBROOK TERRACE
Practice Address - State:IL
Practice Address - Zip Code:60181-3938
Practice Address - Country:US
Practice Address - Phone:630-620-8099
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-07
Last Update Date:2020-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0190326621223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice