Provider Demographics
NPI:1891019840
Name:SOLEIMANI, LAUREN SOFEN (PT, DPT)
Entity Type:Individual
Prefix:DR
First Name:LAUREN
Middle Name:SOFEN
Last Name:SOLEIMANI
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:DR
Other - First Name:LAUREN
Other - Middle Name:BETH
Other - Last Name:SOFEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT, DPT
Mailing Address - Street 1:1311 MAMARONECK AVE STE 140
Mailing Address - Street 2:
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10605-5224
Mailing Address - Country:US
Mailing Address - Phone:914-294-4050
Mailing Address - Fax:
Practice Address - Street 1:407 N LA GRANGE RD
Practice Address - Street 2:
Practice Address - City:LA GRANGE PARK
Practice Address - State:IL
Practice Address - Zip Code:60526-5623
Practice Address - Country:US
Practice Address - Phone:708-482-9320
Practice Address - Fax:708-482-9760
Is Sole Proprietor?:No
Enumeration Date:2010-03-19
Last Update Date:2023-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070-017704225100000X
MI5501016476225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist