Individual
LAYNE ALEXANDER PHILLIPS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O
Contact information
Practice address
1325 COMMUNITY MEMORIAL DR, LA GRANGE, IL 60525-2659
(708) 245-8900
Mailing address
1325 COMMUNITY MEMORIAL DR, LA GRANGE, IL 60525-2659
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036136490
IL
Other
Enumeration date
07/05/2012
Last updated
03/25/2021
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