Provider Demographics
NPI:1053601013
Name:SCHULTZ, LAUREN ELIZABETH (DDS)
Entity type:Individual
Prefix:DR
First Name:LAUREN
Middle Name:ELIZABETH
Last Name:SCHULTZ
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:933 N NORTHWEST HWY
Mailing Address - Street 2:300
Mailing Address - City:PARK RIDGE
Mailing Address - State:IL
Mailing Address - Zip Code:60068-5900
Mailing Address - Country:US
Mailing Address - Phone:847-698-1199
Mailing Address - Fax:847-655-6785
Practice Address - Street 1:933 N NORTHWEST HWY
Practice Address - Street 2:300
Practice Address - City:PARK RIDGE
Practice Address - State:IL
Practice Address - Zip Code:60068-5900
Practice Address - Country:US
Practice Address - Phone:847-698-1199
Practice Address - Fax:847-655-6785
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-12
Last Update Date:2015-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019.0287091223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice