Provider Demographics
NPI:1184199531
Name:SABBATH, LAUREN ASHLEY (FNP-C)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:ASHLEY
Last Name:SABBATH
Suffix:
Gender:
Credentials:FNP-C
Other - Prefix:
Other - First Name:LAUREN
Other - Middle Name:
Other - Last Name:HUSS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:1145 VAN BUREN AVE
Mailing Address - Street 2:
Mailing Address - City:DES PLAINES
Mailing Address - State:IL
Mailing Address - Zip Code:60018-1558
Mailing Address - Country:US
Mailing Address - Phone:217-390-5601
Mailing Address - Fax:
Practice Address - Street 1:6201 W HOWARD ST STE 211A
Practice Address - Street 2:
Practice Address - City:NILES
Practice Address - State:IL
Practice Address - Zip Code:60714-3435
Practice Address - Country:US
Practice Address - Phone:708-428-2996
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-11
Last Update Date:2025-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL041409897163WC0400X
IL277002653363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WC0400XNursing Service ProvidersRegistered NurseCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL209.019680Medicaid