Individual
DR. LAVERNE MONISE BARNES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO, MPH
Contact information
Practice address
31 W 155TH ST, HARVEY, IL 60426-3556
(708) 596-5177
(708) 522-0410
Mailing address
31 W 155TH ST, HARVEY, IL 60426-3556
(708) 596-5177
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036110716
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
F400223220
MEDICARE PTAN
IL
Enumeration date
07/17/2006
Last updated
12/06/2023
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