Lavine, Michael

Lavine, Michael is an individual health care provider with primary practice located at 430 Pennsylvania Ave , Glen Ellyn IL 60137-4464. He recently has only one registered license in Allopathic & Osteopathic Physicians / Diagnostic Radiology, which is considered as his primary health care specialty. Lavine, Michael can be contacted via phone (630) 469-9200.

Contact Information

Primary practice address
430 Pennsylvania Ave Glen Ellyn IL 60137-4464
Phone: (630) 469-9200
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X 036063940 Illinois

Profile Details

NPI number 1619943586
LBN Legal business name Lavine, Michael
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 28th, 2006
Last updated Oct 2nd, 2019 - about 5 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 1619943586 NPPES
Illinois MEDICAID 036063940

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