Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 036057248 | IL |
Y | 207XS0117X | Orthopaedic Spine Surgeon | 036057248 | IL |
NPI | 1023100633 |
---|---|
Provider Name | Dr. Mark A. Lorenz |
First Address | Hinsdale, IL 60521-3186 |
Second Address | Hinsdale, IL 60521-3186 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/09/2006 |
Last Update Date | 31/10/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
036057248 | (05) | IL |
D15278 | (02) |