Organization
LURIE CHILDREN'S MEDICAL GROUP
Active
Other names
LCMG Specialty Services
Organization subpart
No
Provider details
NPI number
Authorized official
LISA LENZ MBA (DIRECTOR)
(312) 227-7121
Entity
Organization
Contact information
Practice address
225 E CHICAGO AVE, CHICAGO, IL 60611-2991
(312) 227-4000
Mailing address
225 E CHICAGO AVE, #64, CHICAGO, IL 60611-2991
(312) 227-7200
(312) 227-9105
Taxonomy
Speciality
Code
Description
License number
State
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1637685
BCBS
IL
Enumeration date
11/28/2006
Last updated
01/28/2014
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