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Individual

DR. GERALD LASIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
900 N WESTMORELAND RD, SUITE 110, LAKE FOREST, IL 60045-1674
(847) 295-1220
(847) 295-1255
Mailing address
900 N WESTMORELAND RD, SUITE 110, LAKE FOREST, IL 60045-1674
(847) 295-1220
(847) 295-1255

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
36038061
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
36038061
IL
Enumeration date
06/18/2006
Last updated
06/22/2010
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