Individual
HAZEL J LANGCAUON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
5775 E STATE ROUTE 113, COAL CITY, IL 60416-7111
(815) 634-0100
Mailing address
350 N WALL ST, KANKAKEE, IL 60901-2901
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036126883
IL
Other
Enumeration date
08/02/2011
Last updated
08/02/2011
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