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Individual

DR. JAMES ROBERT LORD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.P.M.

Contact information

Practice address
269 W ELK TRL, CAROL STREAM, IL 60188-9373
(630) 681-1173
(630) 868-3948
Mailing address
269 W ELK TRL, CAROL STREAM, IL 60188-9373
(630) 681-1173
(630) 868-3948

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
2115
MA
213EP1101X
Primary Podiatric Medicine Podiatrist
Primary
016004900
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
016004900
IL
01
316001998
CONTOLLED SUBSTANCE #
IL
01
Y71049
BLUE CROSS
IL
Enumeration date
07/31/2006
Last updated
03/07/2023
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