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Individual

LAWRENCE D. LIEBER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
4115 FAIRVIEW AVE, DOWNERS GROVE, IL 60515-2268
(630) 968-1881
(630) 968-3762
Mailing address
4300 COMMERCE CT, SUITE 230, LISLE, IL 60532-3698
(630) 968-1881
(630) 245-9098

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
036076570
IL
207XS0114X
Adult Reconstructive Orthopaedic Surgery Physician
036076570
IL
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
036076570
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
036076570
IL
01
200013541
RAILROAD MEDICARE
IL
Enumeration date
09/27/2005
Last updated
03/04/2008
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