Individual
DR. GIANLUCA LAZZARO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
100 E BELLEVUE PL, 19B, CHICAGO, IL 60611-1157
(312) 480-1945
Mailing address
100 E BELLEVUE PL, 19B, CHICAGO, IL 60611-1157
(312) 480-1945
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
036-097662
IL
2086X0206X
Surgical Oncology Physician
036-097662
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01615715
BLUE CROSS BLUE SHIELD
IL
Enumeration date
01/09/2007
Last updated
04/26/2021
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