Individual
ELIZABETH J LAVOO
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
201 E HURON ST, GALTER PAV 11-230, CHICAGO, IL 60611-3197
(312) 642-6868
Mailing address
PO BOX 249, WILMETTE, IL 60091-0249
(847) 676-0091
(847) 676-2374
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
21609751
BLUE CROSS BLUE SHIELD
IL
Enumeration date
03/15/2006
Last updated
07/08/2007
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