Individual
DR. MARK LANZEROTTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3801 IRELAND GROVE RD, BLOOMINGTON, IL 61704-5297
(309) 664-0101
Mailing address
PO BOX 489, BLOOMINGTON, IL 61702-0489
(309) 585-0283
(309) 585-0283
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
036090304
IL
207L00000X
Anesthesiology Physician
70231
TN
Other
Enumeration date
12/22/2005
Last updated
03/11/2024
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