Provider Demographics
NPI:1366591711
Name:SANDERS, LAURA K (MD)
Entity type:Individual
Prefix:DR
First Name:LAURA
Middle Name:K
Last Name:SANDERS
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:10436 SOUTHWEST HWY
Mailing Address - Street 2:STE 1
Mailing Address - City:CHICAGO RIDGE
Mailing Address - State:IL
Mailing Address - Zip Code:60415-2284
Mailing Address - Country:US
Mailing Address - Phone:708-873-0088
Mailing Address - Fax:708-423-4216
Practice Address - Street 1:10436 SOUTHWEST HWY
Practice Address - Street 2:STE 1
Practice Address - City:CHICAGO RIDGE
Practice Address - State:IL
Practice Address - Zip Code:60415-2284
Practice Address - Country:US
Practice Address - Phone:708-952-0109
Practice Address - Fax:708-952-0329
Is Sole Proprietor?:No
Enumeration Date:2007-01-08
Last Update Date:2023-04-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL036-107420207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036-107420Medicaid
ILL93722Medicare PIN
IL036-107420Medicaid