Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | 36050848 | IL |
N | 207VX0000X | Obstetrician | 54280 | KY |
NPI | 1124078795 |
---|---|
Provider Name | Dr. Jeffrey Lerch |
First Address | Northbrook, IL 60062-4936 |
Second Address | Brookfield, IL 60513-1252 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/05/2006 |
Last Update Date | 22/09/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
36050848 | (05) | IL |
C41039 | (02) | IL |