Healthcare Provider Details

I. General information

NPI: 1124078795
Provider Name (Legal Business Name): JEFFREY W LERCH MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/12/2006
Last Update Date: 03/02/2026
Certification Date: 03/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9230 BROADWAY AVE
BROOKFIELD IL
60513-1252
US

IV. Provider business mailing address

4219 RIDGELAND LN
NORTHBROOK IL
60062-4936
US

V. Phone/Fax

Practice location:
  • Phone: 708-387-1109
  • Fax: 708-387-9649
Mailing address:
  • Phone: 847-275-7419
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number036050848
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code207VX0000X
TaxonomyObstetrics Physician
License Number54280
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: