Individual
MR. LAWRENCE JAMES C CALONCAGON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
820 S DAMEN AVE, CHICAGO, IL 60612-3728
(312) 569-8387
Mailing address
9103 KEATING AVE, APT 1A, SKOKIE, IL 60076-1569
(773) 791-2492
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
041.420568
IL
Other
Enumeration date
07/09/2015
Last updated
07/09/2015
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