Provider Demographics
NPI:1457974123
Name:MOHAN, LAUREN SULOCHANA
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:SULOCHANA
Last Name:MOHAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2356 MOHAWK LN
Mailing Address - Street 2:
Mailing Address - City:GLENVIEW
Mailing Address - State:IL
Mailing Address - Zip Code:60026-1058
Mailing Address - Country:US
Mailing Address - Phone:847-610-0926
Mailing Address - Fax:847-272-5822
Practice Address - Street 1:2356 MOHAWK LN
Practice Address - Street 2:
Practice Address - City:GLENVIEW
Practice Address - State:IL
Practice Address - Zip Code:60026-1058
Practice Address - Country:US
Practice Address - Phone:847-610-0926
Practice Address - Fax:847-272-5822
Is Sole Proprietor?:No
Enumeration Date:2020-05-28
Last Update Date:2021-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program