| |
71 Waukegan Rd, Suite 200, Lake Bluff, IL 60044-1662 | |
(847) 295-9300 | |
(847) 295-9607 |
Full Name | |
---|---|
Type | Facility |
Speciality | Podiatrist |
Location | 71 Waukegan Rd, Lake Bluff, Illinois |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1669513982 | NPI | - | NPPES |
000102466006 | Other | IL | UNITED HEALTH CARE |
60021233 | Other | IL | BLUE CROSS BLUE SHIELD |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
213E00000X | Podiatrist | 016003095 (Illinois) | Primary |
Mailing Address | Practice Location Address |
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71 Waukegan Rd, Suite 200, Lake Bluff, IL 60044-1662 Ph: (847) 295-9300 | 71 Waukegan Rd, Suite 200, Lake Bluff, IL 60044-1662 Ph: (847) 295-9300 |
Lawrence Alan Short, DPM Podiatrist Medicare: Not Enrolled in Medicare Practice Location: 71 Waukegan Road, Suite 200, Lake Bluff, IL 60044 Phone: 847-295-9301 Fax: 847-295-9607 |