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General NPI Number Information
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NPI Number | 1659834794
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Entity Type | Individual
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Provider Name | JOEL JONATHAN LANGE MD
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Gender | Male
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Dates
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Enumeration Date | 04/06/2019
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Last Update Date | 10/03/2023
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Provider Practice Location Address
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Address Line | 900 23RD ST NW
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City | WASHINGTON
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State | DC
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Zip | 20037-2342
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Country | US
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Telephone | 202-715-4000
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Fax |
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Provider Business Mailing Address
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Address Line | 2324 HAIDER AVE
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City | NAPERVILLE
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State | IL
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Zip | 60564-4302
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Country | US
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Telephone | 630-862-8687
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Fax |
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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 | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 2023-01504
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License Number State | NC
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