Gray, Lawrence A

Gray, Lawrence A is an individual health care provider with primary practice located at 225 E Chicago Ave , Chicago IL 60611-2991. He recently has only one registered license in Allopathic & Osteopathic Physicians / Developmental – Behavioral Pediatrics, which is considered as his primary health care specialty. Gray, Lawrence A can be contacted via phone (800) 543-7362.

Contact Information

Primary practice address
225 E Chicago Ave Chicago IL 60611-2991
Phone: (800) 543-7362
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Developmental – Behavioral Pediatrics 2080P0006X 036091133 Illinois

Profile Details

NPI number 1659421691
LBN Legal business name Gray, Lawrence A
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 11th, 2007
Last updated Oct 19th, 2018 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1659421691 NPPES
Illinois MEDICAID 036091133

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