Individual
ERNEST WILLIAM LAO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4440 N KEDZIE AVE # U-401, CHICAGO, IL 60625-6880
(312) 576-0863
Mailing address
4440 N KEDZIE AVE # U-401, CHICAGO, IL 60625-6880
(312) 576-0863
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
070016310
IL
Other
Enumeration date
12/18/2014
Last updated
12/18/2014
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