Individual
DR. LAURA BIANCONI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
4309 W MEDICAL CENTER DR STE B310, MCHENRY, IL 60050
(815) 338-6600
(815) 759-4692
Mailing address
4309 W MEDICAL CENTER DR STE B310, MCHENRY, IL 60050-8441
(815) 338-6600
(815) 759-4692
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
036088093
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
036-088093
STATE LICENSE
IL
01
—
370022706
MEDICARE RAILROAD CARRIER
IL
Enumeration date
05/03/2006
Last updated
10/19/2018
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