Lauren Detjen, FNP-BC is a medicare enrolled "Nurse Practitioner - Family" in Kenilworth, Illinois. Her current practice location is
534 Green Bay Rd, Kenilworth, Illinois. You can reach out to her office (for appointments etc.) via phone at
(847) 256-5505.
Lauren Detjen is licensed to practice in Illinois (license number 209.020634) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1447899620.
Provider's Profile
Full Name | Lauren Detjen |
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Gender | Female |
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Speciality | Nurse Practitioner - Family |
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Location | 534 Green Bay Rd, Kenilworth, Illinois |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1447899620
- Provider Enumeration Date: 01/05/2020
- Last Update Date: 01/05/2020
Medicare PECOS Information:
- PECOS PAC ID: 5799109542
- Enrollment ID: I20200727001234
Medical Identifiers
Medical identifiers for Lauren Detjen such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1447899620 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
363LF0000X | Nurse Practitioner - Family | 209.020634 (Illinois) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Lauren Detjen allows following entities to bill medicare on her behalf.
Entity Name | Kenilworth Medical Associates, S.c. |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1366579054 PECOS PAC ID: 2769677293 Enrollment ID: O20101110000776 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Lauren Detjen is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Lauren Detjen, FNP-BC 3241 W Palmer St Apt 2e, Chicago, IL 60647-0899 Ph: (614) 915-7763 | Lauren Detjen, FNP-BC 534 Green Bay Rd, Kenilworth, IL 60043-1801 Ph: (847) 256-5505 |
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