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Individual

DOUGLAS ANDREW LANOUE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
912 W. SEMINARY AVE, ONARGA, IL 60955
(815) 268-4843
(815) 268-4845
Mailing address
1120 N MELVIN ST, GIBSON CITY, IL 60936-1477
(815) 268-4840
(815) 268-4845

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036127703
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
370647938
MOLINA NUMBER
IL
Enumeration date
08/12/2008
Last updated
08/18/2020
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