Individual
DR. LAWRENCE A RUDNICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1044 N MOZART ST STE 405, CHICAGO, IL 60622-2790
(773) 292-8388
(773) 278-1242
Mailing address
2162 MINT LN, GLENVIEW, IL 60026-8014
(847) 724-7960
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
036081384
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
04927890
BLUE CROSS/SHIELD
IL
01
—
P00356886
RAIL ROAD MEDICARE
IL
Enumeration date
07/31/2006
Last updated
07/10/2008
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