Provider Demographics
NPI:1851630800
Name:NELSON, LAUREN ELIZABETH (DC)
Entity Type:Individual
Prefix:DR
First Name:LAUREN
Middle Name:ELIZABETH
Last Name:NELSON
Suffix:
Gender:F
Credentials:DC
Other - Prefix:MS
Other - First Name:LAUREN
Other - Middle Name:ELIZABETH
Other - Last Name:GATLIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BEHAVIOR ANALYST
Mailing Address - Street 1:3000 WOODCREEK DR
Mailing Address - Street 2:SUITE 120
Mailing Address - City:DOWNERS GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60515-5401
Mailing Address - Country:US
Mailing Address - Phone:630-519-3239
Mailing Address - Fax:816-984-8281
Practice Address - Street 1:3000 WOODCREEK DR
Practice Address - Street 2:SUITE 120
Practice Address - City:DOWNERS GROVE
Practice Address - State:IL
Practice Address - Zip Code:60515-5401
Practice Address - Country:US
Practice Address - Phone:630-519-3239
Practice Address - Fax:816-984-8281
Is Sole Proprietor?:No
Enumeration Date:2013-02-12
Last Update Date:2014-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038012624111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor