Provider Demographics
NPI:1720202955
Name:PAULSEN, ERIN MARIE (DN)
Entity Type:Individual
Prefix:DR
First Name:ERIN
Middle Name:MARIE
Last Name:PAULSEN
Suffix:
Gender:F
Credentials:DN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:850 DES PLAINES AVE
Mailing Address - Street 2:UNIT 505
Mailing Address - City:FOREST PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60130-2082
Mailing Address - Country:US
Mailing Address - Phone:847-696-2772
Mailing Address - Fax:
Practice Address - Street 1:6133 N RIVER RD
Practice Address - Street 2:SUITE 199L
Practice Address - City:ROSEMONT
Practice Address - State:IL
Practice Address - Zip Code:60018-5181
Practice Address - Country:US
Practice Address - Phone:847-696-2772
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL172P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172P00000XOther Service ProvidersNaprapath