LAURA NEILSEN (NPI# 1285886721) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1285886721 |
| Entity Type | Individual |
| Full Name | LAURA NEILSEN |
| Credential | PA-C |
| Practice Address |
9150 Crawford Ave Ste 107 Skokie IL 60076-1769 |
| Practice Telephone | 8473297799 |
| Mailing Telephone | 8473297799 |
| Enumeration Date | 2008-10-15 |
| Last Update Date | 2019-08-01 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
085-003311 | IL | Allopathic & Osteopathic Physicians |
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
085003311 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | IL STATE LICENSE | 085003311 | 01 |
| Street Address |
9150 CRAWFORD AVE STE 107 |
| City | SKOKIE |
| State | IL |
| Zip Code | 60076-1769 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962785576 | Mary Kathleen Mcgowan Gruber | Social Worker | 9150 Crawford Ave Ste 107, Skokie, IL 60076-1769 | 2011-09-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902456999 | Gateway Foundation, Inc | Clinic/Center | 4028 W. Dempster, Ste 100, Skokie, IL 60076 | 2019-09-12 |
| 1336798255 | Renee Rosenberg | Speech-Language Pathologist | C/o East Prairie School, 7616 N. East Prairie Road, Skoke, IL 60076 | 2019-09-04 |
| 1710531223 | Dw Care Solutions | Hospice Care, Community Based | 4556 Oakton St, Suite 205, Skokie, IL 60076 | 2019-08-01 |
| 1689228157 | Elaine Ng | Pharmacist | 9650 Gross Point Rd Suite 4900, Skokie, IL 60076 | 2019-08-01 |
| 1881169381 | Kathleen Pyles | Registered Nurse | 9650 Gross Point Rd # 4900, Skokie, IL 60076 | 2018-10-10 |
| 1174013452 | Vitae Health of Illinois LLC | Social Worker | 3450 Oakton St, Skokie, IL 60076 | 2018-05-13 |
| 1396253530 | Jodi Novick Okner | Social Worker | 9134 Kilbourn Avenue, Skokie, IL 60076 | 2018-01-22 |
| 1700335924 | Olumide Adeyemo | Nurse Practitioner | 4711 Golf Rd Suite 1250, Skokie, IL 60076 | 2016-09-28 |
| 1255705315 | Malka Rokach | Pharmacist | 3358 W Touhy, Skokie, IL 60076 | 2015-11-30 |
| 1578932620 | Katrina Margaret Keithley | Physician Assistant | 9669 Kenton Ave Ste 203, Skokie, IL 60076 | 2015-09-18 |
| Find all providers in zip 60076 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104243989 | Christopher James Broz | Physician Assistant | 4626 Old Orchard Rd, Skokie, IL 60076-1009 | 2014-03-18 |
| 1205138617 | Nausheen Zainab Khan | Physician Assistant | 4453 Main St, Skokie, IL 60076-2030 | 2010-11-18 |
| 1255470431 | Jennifer R Ellis | Physician Assistant | 5230 Old Orchard Rd, Skokie, IL 60077-1034 | 2007-02-05 |
| 1932198322 | Jennifer Centore-lober | Physician Assistant | 9711 Skokie Blvd, Skokie, IL 60077-1384 | 2005-10-18 |
| 1154607711 | Monica Taryn Witte | Physician Assistant | 9600 Gross Point Rd, Skokie, IL 60076-1214 | 2011-10-27 |
| 1205143567 | Justin Robert Anthony | Physician Assistant | 9600 Gross Point Rd, Skokie, IL 60076-1214 | 2010-09-08 |
| 1184869208 | Marina A Birman | Physician Assistant | 4555 Oakton St, Skokie, IL 60076-3178 | 2008-12-03 |
| 1083747257 | Michele Lynn Winiarz | Physician Assistant | 9669 Kenton Ave, Suite 300, Skokie, IL 60076-1266 | 2007-03-14 |
| 1487751624 | Erin Kathleen Melley | Physician Assistant | 9711 Skokie Blvd, Ste. J, Skokie, IL 60077-1384 | 2006-09-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831707298 | Eliza Ballen | Physician Assistant | 335 Sylvan Rd, Lake Bluff, IL 60044-2562 | 2020-07-21 |
| 1477177947 | Rybecca Janovyak | Physician Assistant | 14432 High Rd, Lockport, IL 60441-9402 | 2020-06-01 |
| 1518591759 | Julie Jenkot | Physician Assistant | 333 N Michigan Ave Fl 14, Chicago, IL 60601-3901 | 2020-02-26 |
| 1801429873 | Hinjal D Jha | Physician Assistant | 22285 N Pepper Rd Ste 409, Lake Barrington, IL 60010-2542 | 2020-02-19 |
| 1770120222 | Alvina Shaikh | Physician Assistant | 4009 Warren Ave, Bellwood, IL 60104-2066 | 2019-12-03 |
| 1457997561 | Jasleen Mohini Singh | Physician Assistant | 1645a W School Street, Suite A, Clinic Entrance, Chicago, IL 60657 | 2019-11-24 |
| 1538705272 | Bethany Mae Frisby | Physician Assistant | 8630 W Golf Rd, Niles, IL 60714-5600 | 2019-11-18 |
| 1134761984 | Ella-marie Rakowski | Physician Assistant | 25 Acorn Dr, Hawthorn Woods, IL 60047-7407 | 2019-10-14 |
| 1467001859 | Timothy Omotayo Adesanya | Physician Assistant | Graham Correctional Center, 12078 Illinois Rte 185, Hilliboro, IL 62049 | 2019-09-09 |
| 1518514066 | Victoria Moore | Physician Assistant | 979 W Main St, West Dundee, IL 60118-2088 | 2019-08-20 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.