Individual
DR. LAURA M LEBEAU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.P.M.
Contact information
Practice address
2124 S AUSTIN BLVD, CICERO, IL 60804-2012
(708) 863-5376
(708) 863-5375
Mailing address
2124 S AUSTIN BLVD, CICERO, IL 60804-2012
(708) 863-5376
(708) 863-5375
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
016004478
IL
213E00000X
Podiatrist
835025
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
016004478
—
IL
01
—
0732240001
DEMERC # WITH PPG
—
01
—
60000161
BLUE CROSS BLUE SHIELD
—
Enumeration date
05/17/2006
Last updated
06/23/2014
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