Individual
DR. LAWRENCE TIMOTHY KACMAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3965 75TH ST, SUITE 103, AURORA, IL 60504-7925
(630) 375-1625
(630) 375-1925
Mailing address
3965 75TH ST, SUITE 103, AURORA, IL 60504-7925
(630) 375-1625
(630) 375-1925
Taxonomy
Speciality
Code
Description
License number
State
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
036-091557
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0002232125
BLUECROSS/BLUESHIELD
IL
05
—
036091557
—
IL
01
—
17167232
UNITED HEALTHCARE
IL
Enumeration date
10/05/2006
Last updated
02/26/2014
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