MEDICARE: LASANTE INC

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	207X00000X	Orthopaedic Surgery Physician

General Provider Information

NPI Number	:	1760792329
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LASANTE INC

Provider Business Mailing Address
First Line	:	4936 LAVERNA ROAD
Second Line	:
City	:	SPRINGFIELD
State	:	IL
Zip	:	62707-9797
Country	:	US
Telephone Number	:	217-523-4747
Fax Number	:	217-523-0542

Provider Business Practice Location Address
First Line	:	4936 LAVERNA ROAD
Second Line	:
City	:	SPRINGFIELD
State	:	IL
Zip	:	62707-9797
Country	:	US
Telephone Number	:	217-523-4747
Fax Number	:	217-523-0542

Authorized Official
Title or Position	:	CEO
Name	:	DR. FRANK L MIKELL
Credential	:	MD
Telephone Number	:	217-523-4747

Provider Enumeration Date	:	10/18/2010
Last Update Date	:	10/18/2010

Similar Medicare Providers

1467527317 — DR. MICHAEL B HALLE MD
Practice Location Address:

2101 E JEFFERSON ST , KAISER PERMANENTE SPRINGFIELD MEDICARE ENROLLMENT
ROCKVILLE, MD
20852-4908

Practice Phone: 701-922-1000
Practice Fax: 703-922-1039

1275593212 — DR. BONNY CHEN MD
Practice Location Address:

4938 LAVERNA RD
SPRINGFIELD, IL
62707-9797

Practice Phone: 630-481-6502
Practice Fax:

1134174014 — DR. RAYMOND A GENSINGER JR. MD
Practice Location Address:

4938 LAVERNA RD
SPRINGFIELD, IL
62707-9797

Practice Phone: 612-751-8219
Practice Fax:

1609218510 — OJV INC.
Practice Location Address:

4936 LAVERNA RD
SPRINGFIELD, IL
62707-9797

Practice Phone: 217-523-4747
Practice Fax:

1083609747 — DR. BENJAMIN E. MONTGOMERY M.D.
Practice Location Address:

3220 ATLANTA ST STE 100
SPRINGFIELD, IL
62707-8801

Practice Phone: 217-545-8801
Practice Fax: 217-545-4444

1912975160 — DR. HAROLD JAY BRUNINGA M.D.
Practice Location Address:

900 CAPITAL AIRPORT DR
SPRINGFIELD, IL
62707-8410

Practice Phone: 217-473-7386
Practice Fax: 217-473-7386

Directions to “LASANTE INC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.