Provider Demographics
NPI:1881110872
Name:ROMAN, LAUREN (NP-C)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:
Last Name:ROMAN
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1520 COUNTY FARM CT
Mailing Address - Street 2:
Mailing Address - City:WHEATON
Mailing Address - State:IL
Mailing Address - Zip Code:60189-2730
Mailing Address - Country:US
Mailing Address - Phone:630-373-4352
Mailing Address - Fax:
Practice Address - Street 1:1971 GOWDEY RD
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60563-4232
Practice Address - Country:US
Practice Address - Phone:630-416-7293
Practice Address - Fax:630-416-7293
Is Sole Proprietor?:No
Enumeration Date:2017-08-21
Last Update Date:2020-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209016267207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine