Individual
LAWRENCE ALAN SHORT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
71 WAUKEGAN ROAD, SUITE 200, LAKE BLUFF, IL 60044-1662
(847) 295-9301
(847) 295-9607
Mailing address
71 WAUKEGAN RD, SUITE 200, LAKE BLUFF, IL 60044-3009
(847) 295-9301
(847) 295-9607
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
016003095
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000102466006
UNITED HEALTH CARE
IL
01
—
2137407
AETNA
IL
01
—
2502493
CIGNA
IL
01
—
363267075
HUMANA
IL
01
—
60021233
BCBS
IL
Enumeration date
08/21/2006
Last updated
10/01/2012
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