Organization
MARANATHA FAMILY MEDICINE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHESTER GREGORY LASKOWSKI M.D. (OWNER)
(847) 949-8474
Entity
Organization
Contact information
Practice address
550 N MIDLOTHIAN RD, MUNDELEIN, IL 60060-1613
(847) 949-8474
(847) 949-4825
Mailing address
550 N MIDLOTHIAN RD, MUNDELEIN, IL 60060-1613
(847) 949-8474
(847) 949-4825
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036063544
IL
Other
Enumeration date
04/21/2009
Last updated
04/21/2009
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