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General NPI Number Information
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NPI Number | 1699064824
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Entity Type | Individual
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Provider Name | VALERIE LANIOSZ M.D., PHD
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Gender | Female
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Dates
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Enumeration Date | 03/28/2011
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Last Update Date | 09/21/2018
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Provider Practice Location Address
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Address Line | 8110 S CASS AVENUE
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City | DARIEN
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State | IL
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Zip | 60561
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Country | US
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Telephone | 630-920-1900
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Fax | 630-920-1901
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Provider Business Mailing Address
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Address Line | 745 S PARK AVENUE
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City | HINSDALE
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State | IL
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Zip | 60521
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Country | US
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Telephone | 507-284-2511
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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 | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | 036.139570
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | 4301111148
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License Number State | MI
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Taxonomy #3
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | 106244
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License Number State | MN
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Taxonomy #4
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | 55690
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License Number State | MN
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Taxonomy #5
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 125.059193
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License Number State | IL
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