Individual
LYNDA LANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2800 N SHERIDAN RD, SUITE 203, CHICAGO, IL 60657-6156
(773) 404-5263
(773) 404-1867
Mailing address
777 OAKMONT LN, SUITE 1600, WESTMONT, IL 60559-5511
(630) 789-2550
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0031604330
BCBS PROVIDER ID
IL
Enumeration date
09/16/2005
Last updated
01/28/2008
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