Healthcare Provider Details

I. General information

NPI: 1336134931
Provider Name (Legal Business Name): MARIA LASHER D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/20/2005
Last Update Date: 02/17/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2020 OGDEN AVE SUITE 330
AURORA IL
60504-5894
US

IV. Provider business mailing address

2040 OGDEN AVE SUITE 313
AURORA IL
60504-5894
US

V. Phone/Fax

Practice location:
  • Phone: 630-978-4850
  • Fax: 630-978-6865
Mailing address:
  • Phone: 630-978-4850
  • Fax: 630-978-6865

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number036-113346
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: