Individual
JENNIFER LAVIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
676 N SAINT CLAIR ST, SUITE 1325, CHICAGO, IL 60611-2927
(312) 695-3222
Mailing address
676 N ST. CLAIR ST STE 1325, CHICAGO, IL 60611
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
125056137
IL
207YP0228X
Pediatric Otolaryngology Physician
Primary
036138179
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036138179
—
IL
Enumeration date
10/02/2010
Last updated
10/10/2019
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