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General NPI Number Information
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NPI Number | 1164491858
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Entity Type | Individual
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Provider Name | ELIZABETH J LAVOO M.D.
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Gender | Female
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Dates
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Enumeration Date | 03/15/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 201 E HURON ST GALTER PAV 11-230
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City | CHICAGO
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State | IL
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Zip | 60611-3197
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Country | US
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Telephone | 312-642-6868
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 249
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City | WILMETTE
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State | IL
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Zip | 60091-0249
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Country | US
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Telephone | 847-676-0091
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Fax | 847-676-2374
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number |
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License Number State | IL
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