Individual
DR. LAURA J LOUTHAIN-WALROD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
4201 W MEDICAL CENTER DR, MCHENRY, IL 60050
(815) 344-5000
Mailing address
3707 DOTY ROAD, STE F, ATTN: CREDENTIALING, WOODSTOCK, IL 60098
(815) 338-6600
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
036105822
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
036105822
STATE LICENSE
IL
01
—
962341
MEDICARE
IL
Enumeration date
05/02/2006
Last updated
10/19/2018
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