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Individual

MOLLY LUNDY

Active
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Individual

MOLLY LUNDY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
036132003
IL
208000000X
Pediatrics Physician
125.058507
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1189264
AAP ID
IL
01
125.058507
TEMPORARY MEDICAL LICENSE
IL
Enumeration date
06/15/2010
Last updated
02/03/2023
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