Individual
COLLEEN LAVOY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
5841 S MARYLAND AVE, MC 2050, CHICAGO, IL 60637-1447
(773) 834-2365
Mailing address
1526 N. LASALLE ST, APT. 1E, CHICAGO, IL 60610
(419) 367-6318
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085.005287
IL
Other
Enumeration date
11/10/2014
Last updated
04/27/2016
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