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Individual

DR. LAWRENCE K.C. LI

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
2200 FORT JESSE RD, SUITE 250, NORMAL, IL 61761-6286
(309) 454-1616
(309) 454-5167
Mailing address
PO BOX 1645, BLOOMINGTON, IL 61702-1645
(309) 454-1616
(309) 454-5167

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0360924582
IL
Enumeration date
09/28/2005
Last updated
07/08/2007
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