Individual
DR. MARY JACQUES HENRI LAMOUR JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
611 W PARK ST, URBANA, IL 61801-2529
(813) 508-0542
Mailing address
1215 LANCASTER DR, CHAMPAIGN, IL 61821-7001
(813) 508-0542
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
125081013
IL
Other
Enumeration date
06/23/2022
Last updated
06/23/2022
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