Individual
LAWRENCE A GRAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
225 E CHICAGO AVE, CHICAGO, IL 60611-2991
(800) 543-7362
Mailing address
225 E CHICAGO AVE, CHICAGO, IL 60611-2991
(800) 543-7362
Taxonomy
Speciality
Code
Description
License number
State
2080P0006X
Developmental - Behavioral Pediatrics Physician
Primary
036091133
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036091133
—
IL
Enumeration date
01/11/2007
Last updated
10/19/2018
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