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General NPI Number Information
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NPI Number | 1710328224
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Entity Type | Individual
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Provider Name | PAUL GREGORY LANTZ DPM
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Gender | Male
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Dates
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Enumeration Date | 07/12/2013
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Last Update Date | 08/05/2020
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Provider Practice Location Address
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Address Line | 5758 S MARYLAND AVE # NC9015
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City | CHICAGO
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State | IL
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Zip | 60637-1426
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Country | US
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Telephone | 773-834-7711
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Fax | 773-834-7205
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Provider Business Mailing Address
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Address Line | 5758 S MARYLAND AVE # NC9015
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City | CHICAGO
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State | IL
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Zip | 60637-1426
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Country | US
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Telephone | 773-834-7711
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Fax | 773-834-7205
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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 | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | 000878
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License Number State | IA
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Taxonomy #2
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | 016.005737
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License Number State | IL
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