Organization
LAWRENCE H ITELD, MD, LLC
Active
Other names
Lincoln Park Plastic Surgery
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LAWRENCE HAL ITELD M.D. (PRESIDENT/ OWNER)
(312) 757-4505
Entity
Organization
Contact information
Practice address
939 W NORTH AVE STE 600, CHICAGO, IL 60642-7138
(312) 757-4505
Mailing address
939 W NORTH AVE STE 600, CHICAGO, IL 60642-7138
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
036-108014
IL
Other
Enumeration date
10/29/2013
Last updated
06/17/2020
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