Individual
DR. LAURA LEE LOESEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
520 N 4TH ST, SPRINGFIELD, IL 62702-5238
(217) 757-8100
(217) 747-1351
Mailing address
PO BOX 19670, SPRINGFIELD, IL 62794-9670
(217) 757-8100
(217) 747-1351
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036-113362
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036113362
—
IL
Enumeration date
09/28/2006
Last updated
06/14/2011
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