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Individual

JOSEPH MICHAEL LACH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
1051 ESSINGTON RD STE 265, JOLIET, IL 60435-2801
(815) 300-7764
Mailing address
1051 ESSINGTON RD STE 265, JOLIET, IL 60435-2801
(815) 300-7764

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036138941
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
F400249339
MEDICARE PTAN
IL
Enumeration date
03/12/2013
Last updated
08/06/2021
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