Individual
WILFRED LAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
747 N RUTLEDGE ST, 4TH FLOOR, SPRINGFIELD, IL 62702-6700
(217) 788-0706
(217) 788-7032
Mailing address
747 N RUTLEDGE ST, SPRINGFIELD, IL 62702-6700
(217) 788-0706
(217) 788-7032
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
036-057135
IL
207RC0000X
Cardiovascular Disease Physician
Primary
036057135
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036057135
—
IL
01
—
060040344
RAILROAD
IL
Enumeration date
10/19/2006
Last updated
11/30/2012
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