Provider Demographics
NPI:1700822590
Name:SAXE, LAUREN (MD)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:
Last Name:SAXE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18440 GOVERNORS HWY
Mailing Address - Street 2:
Mailing Address - City:HOMEWOOD
Mailing Address - State:IL
Mailing Address - Zip Code:60430-2911
Mailing Address - Country:US
Mailing Address - Phone:708-798-2191
Mailing Address - Fax:708-798-2317
Practice Address - Street 1:18440 GOVERNORS HWY
Practice Address - Street 2:
Practice Address - City:HOMEWOOD
Practice Address - State:IL
Practice Address - Zip Code:60430-2911
Practice Address - Country:US
Practice Address - Phone:708-798-2191
Practice Address - Fax:708-798-2317
Is Sole Proprietor?:No
Enumeration Date:2006-06-21
Last Update Date:2010-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036079170207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILL64595OtherPTAN
ILL64595Medicare ID - Type Unspecified
ILL64595OtherPTAN
ILL64595Medicare PIN