Individual
MR. CHARLES LAWLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3700 S WALLACE ST, CHICAGO, IL 60609-1745
(773) 247-1900
(773) 247-8892
Mailing address
2525 S MICHIGAN AVE, B-390, CHICAGO, IL 60616-2333
(312) 567-6691
(312) 328-7895
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
036078328
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01621679
BCBS OF IL
IL
05
—
036078328 /02
—
IL
Enumeration date
11/29/2005
Last updated
08/04/2011
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