Provider Demographics
NPI:1083344782
Name:ROSIER-ELLSWORTH, LAUREN O (MS, LCGC)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:O
Last Name:ROSIER-ELLSWORTH
Suffix:
Gender:F
Credentials:MS, LCGC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9500 EUCLID AVE # C15
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44195-0001
Mailing Address - Country:US
Mailing Address - Phone:216-780-9302
Mailing Address - Fax:
Practice Address - Street 1:1000 CENTRAL ST STE 610
Practice Address - Street 2:
Practice Address - City:EVANSTON
Practice Address - State:IL
Practice Address - Zip Code:60201-1780
Practice Address - Country:US
Practice Address - Phone:847-570-2918
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-15
Last Update Date:2025-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH70.000923207SG0203X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207SG0203XAllopathic & Osteopathic PhysiciansMedical GeneticsClinical Molecular GeneticsGroup - Single Specialty