Provider Demographics
NPI:1649615733
Name:AUDEN, ANNIE-LAURIE (MD)
Entity type:Individual
Prefix:DR
First Name:ANNIE-LAURIE
Middle Name:
Last Name:AUDEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:808 S WOOD ST
Mailing Address - Street 2:469 CME, M/C 724
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60612-7300
Mailing Address - Country:US
Mailing Address - Phone:312-413-7492
Mailing Address - Fax:
Practice Address - Street 1:808 S WOOD ST
Practice Address - Street 2:469 CME, M/C 724
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60612-7300
Practice Address - Country:US
Practice Address - Phone:312-413-7492
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-05-03
Last Update Date:2021-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program