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General NPI Number Information
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NPI Number | 1346833753
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Entity Type | Organization
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Legal Business Name | DR. LAVINIA L MYERS, PC
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Dates
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Enumeration Date | 02/17/2021
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Last Update Date | 09/12/2021
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Provider Practice Location Address
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Address Line | 16W281 83RD ST STE B
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City | BURR RIDGE
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State | IL
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Zip | 60527-7967
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Country | US
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Telephone | 630-581-7798
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Fax | 630-581-7799
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Provider Business Mailing Address
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Address Line | 16W281 83RD ST STE B
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City | BURR RIDGE
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State | IL
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Zip | 60527-7967
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Country | US
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Telephone | 630-581-7798
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Fax | 630-581-7799
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Authorized Official
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Title or Position | PRESIDENT
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Name | LAVINIA MYERS
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Credential | MD
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Telephone | 708-860-7290
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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