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General NPI Number Information
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NPI Number | 1306031885
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Entity Type | Organization
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Legal Business Name | DRS. LAMORENA LTD
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Dates
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Enumeration Date | 09/07/2007
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Last Update Date | 09/07/2007
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Provider Practice Location Address
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Address Line | 5356 W DIVERSEY AVE
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City | CHICAGO
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State | IL
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Zip | 60639-1513
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Country | US
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Telephone | 773-777-9400
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Fax | 773-777-6917
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Provider Business Mailing Address
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Address Line | 4909 W DIVISION ST SUITE 208
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City | CHICAGO
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State | IL
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Zip | 60651-3161
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Country | US
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Telephone | 773-626-8833
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Fax | 773-777-6917
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Authorized Official
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Title or Position | VICE PRESIDENT AND TREASURER
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Name | DR. BIENVENIDO TECSON LAMORENA
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Credential | M.D
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Telephone | 773-626-8833
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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