Provider Demographics
NPI:1962455998
Name:PACHMAN, LAUREN M (MD)
Entity Type:Individual
Prefix:MRS
First Name:LAUREN
Middle Name:M
Last Name:PACHMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:225 E CHICAGO AVE
Mailing Address - Street 2:BOX 50
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-2991
Mailing Address - Country:US
Mailing Address - Phone:312-227-6270
Mailing Address - Fax:312-227-9417
Practice Address - Street 1:225 E CHICAGO AVE
Practice Address - Street 2:BOX 50
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-2991
Practice Address - Country:US
Practice Address - Phone:312-227-6270
Practice Address - Fax:312-227-9417
Is Sole Proprietor?:No
Enumeration Date:2006-05-19
Last Update Date:2016-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0360393192080P0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0201XAllopathic & Osteopathic PhysiciansPediatricsPediatric Allergy/Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036039319Medicaid
C43712Medicare UPIN
IL036039319Medicaid