Laureen L Ambrose MD SC

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

036-059550 Issued in IL

Legal business name

LAUREEN L AMBROSE MD SC

Practice address

15300 West Ave
Suite 205
Orland Park, IL 60462-4600

Phone

(708) 460-1040

Fax

(708) 460-6872

NPI assigned

Sep 16, 2010

Organization subpart

No

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

Authorized official

Name

Dr. Laureen Ambrose

Title

M.D.

Phone

(708) 460-1040

Specialties & licenses 1

Addresses

Other identifiers 2

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

{
    "created_epoch": "1284595200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1301616000000",
    "number": "1700194339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15300 WEST AVE",
            "address_2": "SUITE 205",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "604624600",
            "telephone_number": "708-460-1040",
            "fax_number": "708-460-6872"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15300 WEST AVE",
            "address_2": "SUITE 205",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "604624600",
            "telephone_number": "708-460-1040",
            "fax_number": "708-460-6872"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAUREEN L AMBROSE MD SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-16",
        "last_updated": "2011-04-01",
        "status": "A",
        "authorized_official_last_name": "AMBROSE",
        "authorized_official_first_name": "LAUREEN",
        "authorized_official_title_or_position": "M.D.",
        "authorized_official_telephone_number": "708-460-1040",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": "IL",
            "license": "036-059550",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "718990",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS & BLUESHIELD",
            "identifier": "31600367",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Obstetrics & Gynecology Physician in Orland Park, IL
• Providers in Orland Park, IL by specialty
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2011; 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.