Lane, George W
Lane, George W is an individual health care provider with primary practice located at 5401 N Knoxville Ave Suite 400, Peoria IL 61614-5098. He recently has only one registered license in Allopathic & Osteopathic Physicians / Orthopaedic Surgery, which is considered as his primary health care specialty. Lane, George W can be contacted via phone (309) 692-6644.Contact Information
Primary practice address
5401 N Knoxville Ave Suite 400
Peoria IL 61614-5098
Phone: (309) 692-6644
Fax: (309) 692-8992
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Orthopaedic Surgery | 207X00000X | 03064025 | Illinois |
Profile Details
| NPI number | 1740227032 |
|---|---|
| LBN Legal business name | Lane, George W |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 2nd, 2006 |
| Last updated | Jun 24th, 2011 - about 15 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1740227032 | NPPES |
| Illinois | Other | 148547 | HEALTHLINK |
| Illinois | Other | 4281670001 | HEALTHLINK |
| Illinois | Other | 200041572 | HEALTHLINK |
| Illinois | Other | 7230175 | HEALTHLINK |
| Illinois | MEDICAID | 036064025 | HEALTHLINK |
| Illinois | Other | IL0102 | HEALTHLINK |
| Illinois | Other | 050053 | HEALTHLINK |
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