Provider Demographics
NPI:1134818875
Name:SANCHEZ, LAUREN ELAINE (APRN)
Entity type:Individual
Prefix:MRS
First Name:LAUREN
Middle Name:ELAINE
Last Name:SANCHEZ
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:MISS
Other - First Name:LAUREN
Other - Middle Name:ELAINE
Other - Last Name:O'DANIELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:650 DAKOTA ST STE A
Mailing Address - Street 2:
Mailing Address - City:CRYSTAL LAKE
Mailing Address - State:IL
Mailing Address - Zip Code:60012-3744
Mailing Address - Country:US
Mailing Address - Phone:845-455-6000
Mailing Address - Fax:815-356-1104
Practice Address - Street 1:650 DAKOTA ST SUITE A
Practice Address - Street 2:
Practice Address - City:CRYSTAL LAKE
Practice Address - State:IL
Practice Address - Zip Code:60012
Practice Address - Country:US
Practice Address - Phone:815-455-6000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-08
Last Update Date:2023-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209.027222363LF0000X
IL209027222363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty