Individual
LAURA ANN KAVLIE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2701 W 68TH ST, CHICAGO, IL 60629-1813
(773) 884-9000
Mailing address
1115 S OAK PARK AVE APT 2, OAK PARK, IL 60304-2616
(616) 558-0693
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085004512
IL
Other
Enumeration date
11/21/2012
Last updated
11/21/2012
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