MEDICARE: LAVERNE CURRIE M.D.

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
1	207R00000X	Internal Medicine Physician		IL

General Provider Information

NPI Number	:	1629003058
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAVERNE CURRIE M.D.

Provider Business Mailing Address
First Line	:	2311 W 22ND ST
Second Line	:	SUITE 202
City	:	OAK BROOK
State	:	IL
Zip	:	60523-1225
Country	:	US
Telephone Number	:	630-320-1160
Fax Number	:

Provider Business Practice Location Address
First Line	:	2301 E 93RD ST
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60617-3913
Country	:	US
Telephone Number	:	773-731-9898
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/12/2006
Last Update Date	:	07/08/2007

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