Desch, Larry Wayne
Desch, Larry Wayne is an individual health care provider with primary practice located at 9555 S 52Nd Ave , Oak Lawn IL 60453-3054. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatrics, Allopathic & Osteopathic Physicians / Neurodevelopmental Disabilities, Allopathic & Osteopathic Physicians / Developmental – Behavioral Pediatrics. Allopathic & Osteopathic Physicians / Developmental – Behavioral Pediatrics is his primary health care specialty. Desch, Larry Wayne can be contacted via phone (847) 318-9330.Contact Information
Primary practice address
9555 S 52Nd Ave
Oak Lawn IL 60453-3054
Phone: (847) 318-9330
Fax: (708) 876-1561
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 036093057 | Illinois |
| Allopathic & Osteopathic Physicians / Neurodevelopmental Disabilities | 2080P0008X | 036093057 | Illinois |
| Allopathic & Osteopathic Physicians / Developmental – Behavioral Pediatrics | 2080P0006X | 036-093057 | Illinois |
Profile Details
| NPI number | 1912016783 |
|---|---|
| LBN Legal business name | Desch, Larry Wayne |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 29th, 2006 |
| Last updated | Dec 17th, 2021 - about 3 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 | 1912016783 | NPPES |
| Illinois | Other | 036093057 | STATE LICENSE |
| Illinois | Other | 14D0419824 | STATE LICENSE |
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