Individual
LAURIE GWEN BROUTMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3333 GREEN BAY RD, NORTH CHICAGO, IL 60064-3037
(847) 578-8530
(847) 578-1019
Mailing address
1039 DEVONSHIRE CT, HIGHLAND PARK, IL 60035-3712
(847) 831-1439
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
IL
Other
Enumeration date
01/25/2007
Last updated
07/08/2007
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