Organization
PHILIP E. LANE MD, SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PHILIP EDWARD LANE MD (PRESIDENT)
(312) 953-0866
Entity
Organization
Contact information
Practice address
2947 W BONNIE BROOK LN, WAUKEGAN, IL 60087-2838
(847) 662-8009
(847) 662-5513
Mailing address
21707 W OLD BARN LN, LAKE ZURICH, IL 60047-1612
(847) 438-5447
(847) 438-9337
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
036-051264
IL
2084P0800X
Psychiatry Physician
Primary
036-030074
IL
Other
Enumeration date
09/14/2009
Last updated
09/14/2009
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