Individual
GARY L LAVELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
1750 GRANDSTAND PL, ELGIN, IL 60123-4900
(847) 931-8113
(847) 931-8113
Mailing address
356 N AIRLITE ST, ELGIN, IL 60123-4971
(847) 931-8113
(847) 931-8113
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
04582084
BLUE SHIELD PROVIDER NO.
IL
Enumeration date
04/13/2007
Last updated
07/09/2007
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