| Doctor Name: | LAUREN ELISE CARQUEVILLE |
| NPI Number: | 1063851830 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | FNP-BC |
| License Number: | 209010482 |
| Business Practice Address: | 5600 Wolf Rd Suite 140 Western Springs, IL - 605582254 |
| Business Phone Number: | 7082467222 |
| Business Fax Number: | |
| Mailing Address: | 5600 Wolf Rd, Suite 140 WESTERN SPRINGS |
| State: | IL |
| Postal Code: | 605582254 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 06/14/2013 |
| NPI Last Update Date: | 09/11/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 209010482 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |