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General NPI Number Information
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NPI Number | 1952628018
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Entity Type | Organization
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Legal Business Name | L LERNER MD SC
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Dates
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Enumeration Date | 04/29/2010
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Last Update Date | 04/29/2010
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Provider Practice Location Address
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Address Line | 600 N MCCLURG CT SUITE 507A
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City | CHICAGO
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State | IL
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Zip | 60611-3044
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Country | US
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Telephone | 708-494-5855
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Fax | 312-787-2427
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Provider Business Mailing Address
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Address Line | 600 N MCCLURG CT SUITE 507A
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City | CHICAGO
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State | IL
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Zip | 60611-3044
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Country | US
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Telephone | 708-494-5855
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Fax | 312-787-2427
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. LAWRENCE LERNER
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Credential | MD
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Telephone | 708-494-5855
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207QA0505X
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Taxonomy Name | Adult Medicine Physician
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License Number | 042619614
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License Number State | IL
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