Individual
LAWRENCE H. ITELD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
939 W NORTH AVE STE 600, CHICAGO, IL 60642-7138
(312) 757-4505
Mailing address
939 W NORTH AVE STE 600, CHICAGO, IL 60642-7138
(312) 757-4505
(312) 757-4605
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
036-108014
IL
208200000X
Plastic Surgery Physician
036108014
IL
Other
Enumeration date
04/21/2006
Last updated
06/17/2020
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