MEDICARE: LAWRENCE LINDEMAN MD SC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician		IL

General Provider Information

NPI Number	:	1730188228
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LAWRENCE LINDEMAN MD SC

Provider Business Mailing Address
First Line	:	PO BOX 872
Second Line	:
City	:	EVANSTON
State	:	IL
Zip	:	60204-0872
Country	:	US
Telephone Number	:	773-832-1081
Fax Number	:	773-832-1082

Provider Business Practice Location Address
First Line	:	2255 W ROSCOE ST
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60618-6238
Country	:	US
Telephone Number	:	773-832-1081
Fax Number	:	773-832-1082

Authorized Official
Title or Position	:	OWNER
Name	:	LAWRENCE A LINDEMAN
Credential	:	M.D.
Telephone Number	:	773-832-1081

Provider Enumeration Date	:	07/18/2005
Last Update Date	:	07/21/2022

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