Organization
LAWRENCE A SHORT DPM LTD
Active
Other names
University Foot Associates
Organization subpart
No
Provider details
NPI number
Authorized official
LAWRENCE ALAN SHORT DPM (PRESIDENT)
(847) 295-9300
Entity
Organization
Contact information
Practice address
71 WAUKEGAN RD, SUITE 200, LAKE BLUFF, IL 60044-1662
(847) 295-9300
(847) 295-9607
Mailing address
71 WAUKEGAN RD, SUITE 200, LAKE BLUFF, IL 60044-1662
(847) 295-9300
(847) 295-9607
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
016003095
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000102466006
UNITED HEALTH CARE
IL
01
—
60021233
BLUE CROSS BLUE SHIELD
IL
Enumeration date
02/09/2007
Last updated
03/26/2009
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