Organization
LAWRENCE T. KACMAR MDSC
Active
Other names
The Center for Primary Care and Sports Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MARGARET M COOLEY (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
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
036091557
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
202522
MEDICARE NUMBER
IL
Enumeration date
06/02/2009
Last updated
06/02/2009
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