Lauren Jayne Lattery, OD, MS

Primary specialty

OptometristTaxonomy code 152W00000X

License

10562 Issued in TX

Practice address

3350 Illinois St
Great Lakes, IL 60088

Phone

(847) 688-5568

NPI assigned

Nov 29, 2022

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Ms. Lauren Jayne Johnson Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Naval Health Clinic Great Lakes

  • Military/U.S. Coast Guard Outpatient Clinic/Center
  • Great Lakes, IL
  • NPI 1144557208
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1669680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669680000000",
    "number": "1659081859",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4122 BITTERNUT LN APT 301",
            "city": "GURNEE",
            "state": "IL",
            "postal_code": "600319351",
            "telephone_number": "952-381-4167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3350 ILLINOIS ST",
            "city": "GREAT LAKES",
            "state": "IL",
            "postal_code": "60088",
            "telephone_number": "847-688-5568"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LATTERY",
        "first_name": "LAUREN",
        "middle_name": "JAYNE",
        "name_prefix": "Dr.",
        "credential": "OD, MS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-11-29",
        "last_updated": "2022-11-29",
        "certification_date": "2022-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "10562",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "10562T",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lauren.j.lattery.mil@health.mil",
            "affiliation": "N",
            "endpointDescription": "Military email address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "3350 Illinois St",
            "city": "Great lakes",
            "state": "IL",
            "country_code": "US",
            "postal_code": "60088",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "LAUREN",
            "last_name": "JOHNSON",
            "middle_name": "JAYNE",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Seth David Koerner, RPH
• Claire Kubiesa, PH.D.
• Glenn A Kurtz, DDS
• Kelly Robert Lanning, DMD
• Clinton Lariscy, IDC
• Don D Lavanway, RPH
• Elinor Grace Layton, DMD
• Marisa Leandro, D.D.S., M.S.
• Daria Hyeri Lee, D.D.S.
• Marshall Lee, PHARMD

• Optometrist in Great Lakes, IL
• Providers in Great Lakes, IL by specialty
• Optometrist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.