Provider Demographics
NPI:1174789820
Name:KATZ PHAM, LAUREN BROOKE (MD)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:BROOKE
Last Name:KATZ PHAM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:LAUREN
Other - Middle Name:BROOKE
Other - Last Name:KATZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:800 E WOODFIELD RD STE 103
Mailing Address - Street 2:
Mailing Address - City:SCHAUMBURG
Mailing Address - State:IL
Mailing Address - Zip Code:60173-4718
Mailing Address - Country:US
Mailing Address - Phone:224-517-5182
Mailing Address - Fax:224-517-3192
Practice Address - Street 1:800 E WOODFIELD RD STE 103
Practice Address - Street 2:
Practice Address - City:SCHAUMBURG
Practice Address - State:IL
Practice Address - Zip Code:60173-4718
Practice Address - Country:US
Practice Address - Phone:224-517-5182
Practice Address - Fax:224-517-3192
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-01
Last Update Date:2024-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036124185207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine