Organization
FAMILY MEDICINE FOR MCHENRY COUNTY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL LESSER MD (PRESIDENT)
(847) 658-2400
Entity
Organization
Contact information
Practice address
1095 PINGREE RD, SUITE 108, CRYSTAL LAKE, IL 60014-1725
(847) 658-2400
(847) 658-7755
Mailing address
PO BOX 1588, CRYSTAL LAKE, IL 60039-1588
(847) 658-2400
(847) 658-7755
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5615119
BCBS PROVIDER NUMBER
IL
Enumeration date
01/20/2006
Last updated
05/20/2021
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