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General NPI Number Information
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NPI Number | 1184945206
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Entity Type | Individual
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Provider Name | REBECCA F LARA M.D.
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Gender | Female
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Dates
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Enumeration Date | 06/14/2010
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Last Update Date | 07/20/2020
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Provider Practice Location Address
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Address Line | 2020 OGDEN AVE STE 330
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City | AURORA
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State | IL
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Zip | 60504-5897
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Country | US
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Telephone | 630-978-4850
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Fax | 630-978-6865
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Provider Business Mailing Address
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Address Line | 2020 OGDEN AVE STE 330
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City | AURORA
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State | IL
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Zip | 60504-5897
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Country | US
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Telephone | 630-978-4850
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Fax | 630-978-6865
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 255309
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 245248
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License Number State | MA
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Taxonomy #3
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 036-148815
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License Number State | IL
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