Individual
DR. JOHN PHILLIP LAVIERI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
206 MARQUETTE STREET, SUITE 311, LA SALLE, IL 61301-2483
(815) 224-1988
(815) 224-3220
Mailing address
206 MARQUETTE STREET, SUITE 311, LA SALLE, IL 61301-2483
(815) 224-1988
(815) 224-3220
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
IL
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
—
IL
Other
Enumeration date
10/03/2006
Last updated
04/04/2008
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