Healthcare Provider Details

I. General information

NPI: 1255357331
Provider Name (Legal Business Name): LAWN MEDICAL CENTER, S.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/14/2006
Last Update Date: 12/28/2021
Certification Date: 12/28/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4301 W 95TH ST
OAK LAWN IL
60453-2670
US

IV. Provider business mailing address

4301 W 95TH ST
OAK LAWN IL
60453-2670
US

V. Phone/Fax

Practice location:
  • Phone: 708-425-5500
  • Fax: 708-425-0771
Mailing address:
  • Phone: 708-425-5500
  • Fax: 708-425-0771

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: MARGARET A GAJDA
Title or Position: PRESIDENT
Credential: D.O.
Phone: 708-425-5500