person
Ellyn M Lawrence
Public Health or Welfare Agency in Tinley Park, Illinois
NPI 1023745874

Ellyn M Lawrence is a Public Health or Welfare Agency based in Tinley Park, IL. Ellyn M Lawrence practices in Tinley Park, IL. The NPI Number for Ellyn M Lawrence is 1023745874 and holds a License No. (Illinois).

The current practice location address for Ellyn M Lawrence is 16820 81St Ct Apt 3S, Tinley Park, IL and can be reached out via phone at 708-704-9671.

Location: 16820 81St Ct Apt 3S, Tinley Park, IL, 60477-2044
person
Provider Profile Details
NPI Number
1023745874
Provider Name
Ellyn M Lawrence
Credential
Provider Entity Type
Individual
Gender
Female
Address
16820 81St Ct Apt 3S, Tinley Park, IL, 60477-2044
Phone Number
708-704-9671
Fax Number
Provider Enumeration Date
08/02/2022
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
VUE822511480 01 IL BLUE CROSS BLUE SHIELD
institution
Provider Business Practice Location Address Details
Address
16820 81St Ct Apt 3S
City
State
Zip
60477-2044
Phone Number
708-704-9671
Fax Number
person
Provider Business Mailing Address Details
Address
16820 81St Ct Apt 3S
City
State
Zip
60477-2044
Phone Number
708-704-9671
Fax Number
person
Provider's Taxonomy Details 1
Type
Agencies
Classification
Public Health or Welfare
Speciality
-
Taxonomy
License No.
()
Definition
Definition to come...
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