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Individual

AMANDA S LAREAU

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
525 E CONGRESS PKWY, DERICK DERMATOLOGY SUITE 200, CRYSTAL LAKE, IL 60014-6245
(847) 381-8899
(847) 381-8999
Mailing address
525 E CONGRESS PKWY, DERICK DERMATOLOGY SUITE 200, CRYSTAL LAKE, IL 60014-6245
(847) 381-8899
(847) 381-8999

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
125059230
IL
207R00000X
Internal Medicine Physician
L-240236
MA

Other

Enumeration date
06/11/2009
Last updated
12/16/2021
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