Doctor Name: | LAURA BOOKER |
NPI Number: | 1104215573 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | |
Business Practice Address: | 12525 Renaissance Cir Homer Glen, IL - 604915896 |
Business Phone Number: | 7085905050 |
Business Fax Number: | |
Mailing Address: | 12525 Renaissance Cir, HOMER GLEN |
State: | IL |
Postal Code: | 604915896 |
Phone Number: | 7085905050 |
Fax Number: | |
NPI Enumeration Date: | 01/22/2015 |
NPI Last Update Date: | 01/22/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 376G00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Nursing Service Related Providers |
Taxonomy Classification: | Nursing Home Administrator |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual, often licensed by the state, who is responsible for the management of a nursing home. |