Individual
MS. JENNIFER ASHLEY LAZOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
1426 W WASHINGTON BLVD, CHICAGO, IL 60607-1821
(312) 829-1424
(312) 850-8431
Mailing address
1426 W. WASHINGTON BLVD., CHICAGO, IL 60607
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
036.136935
IL
207RN0300X
Nephrology Physician
Primary
34.011289
OH
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0112347
—
OH
Enumeration date
03/16/2012
Last updated
12/20/2017
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