Individual
LAVINIA L MYERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2803 BUTTERFIELD RD STE 200, OAK BROOK, IL 60523-1165
(630) 424-9482
(630) 424-4783
Mailing address
PO BOX 5970, VILLA PARK, IL 60181-5312
(847) 805-8833
(630) 424-4783
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
036107284
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2232595
BCBS PROVIDER NUMBER
IL
Enumeration date
09/15/2006
Last updated
02/17/2021
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