Organization
F G L LERNER MD SERVICES LTD
Active
Other names
clinic
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM BLAKE (PRINCIPAL OFFICER)
(312) 842-3700
Entity
Organization
Contact information
Practice address
2100 S INDIANA AVE, STE 111, CHICAGO, IL 60616-1381
(312) 842-3700
Mailing address
2100 S INDIANA AVE, STE 111, CHICAGO, IL 60616-1381
(312) 842-3700
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
11/14/2006
Last updated
08/22/2020
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