Organization
LAWRENCE T. KACMAR M.D., S.C.
Active
Other names
The Center for Primary Care & Sports Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
MARGARET M COOLEY LPN (OFFICE MANAGER)
(630) 375-1625
Entity
Organization
Contact information
Practice address
3965 75TH ST, SUITE 103, AURORA, IL 60504-7925
(630) 375-1625
(630) 375-1925
Mailing address
3965 75TH ST, SUITE 103, AURORA, IL 60504-7925
(630) 375-1625
(630) 375-1925
Taxonomy
Speciality
Code
Description
License number
State
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0005442619
AETNA
IL
01
—
02232125
BLUE CROSS BLUE SHIELD ILLINOIS
IL
05
—
036091557
—
IL
01
—
1767232
UNITED HEALTHCARE
IL
01
—
1903680
CIGNA
IL
Enumeration date
10/05/2006
Last updated
07/23/2008
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