Individual
LANCE RONALD NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1440 N DAYTON ST, CHICAGO, IL 60642-2644
(319) 384-7888
(319) 384-7899
Mailing address
PO BOX 2147, FORT MYERS, FL 33902-2147
(239) 343-6788
(239) 343-4180
Taxonomy
Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
036.160891
IL
2080A0000X
Pediatric Adolescent Medicine Physician
ME175958
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
128758300
—
FL
Enumeration date
06/24/2016
Last updated
11/19/2025
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