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NPI Code Detail

MEDICARE: DRS. LAMORENA LTD

MEDICARE: DRS. LAMORENA LTD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QP2300XPrimary Care Clinic/Center

General Provider Information

NPI Number : 1306031885
Entity Type Code : Organization
Provider Name (Legal Business Name) : DRS. LAMORENA LTD
Provider Business Mailing Address
First Line : 4909 W DIVISION ST
Second Line : SUITE 208
City : CHICAGO
State : IL
Zip : 60651-3161
Country : US
Telephone Number : 773-626-8833
Fax Number : 773-777-6917
Provider Business Practice Location Address
First Line : 5356 W DIVERSEY AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60639-1513
Country : US
Telephone Number : 773-777-9400
Fax Number : 773-777-6917
Authorized Official
Title or Position : VICE PRESIDENT AND TREASURER
Name : DR. BIENVENIDO TECSON LAMORENA
Credential : M.D
Telephone Number : 773-626-8833
Provider Enumeration Date : 09/07/2007
Last Update Date : 09/07/2007

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Directions to “DRS. LAMORENA LTD ” Practice Location

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