Individual
GEORGE W LANE SR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
03064025
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036064025
—
IL
01
—
050053
HEALTH ALLIANCE
IL
01
—
148547
HEALTHLINK
IL
01
—
200041572
RR MEDICARE
IL
01
—
4281670001
DME
IL
01
—
7230175
BLUE CROSS BLUE SHIELD
IL
01
—
IL0102
JOHN DEERE
IL
Enumeration date
06/02/2006
Last updated
06/24/2011
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