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Individual

DR. JOHN VINCENT LACCI JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2740 W FOSTER AVE, CHICAGO, IL 60625-3500
(773) 293-5300
Mailing address
2650 RIDGE AVE, EVANSTON, IL 60201-1700
(847) 982-4869

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
036162333
IL
2084P0800X
Psychiatry Physician
125.076035
IL
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
04/21/2020
Last updated
04/23/2024
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