Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208100000X | Physical Medicine & Rehabilitation Doctor | 125064995 | IL |
Y | 2081S0010X | Sports Medicine | 036.158386 | IL |
Y | 213ES0000X | Sports Medicine | 036.158386 | IL |
NPI | 1063825925 |
---|---|
Provider Name | Dr. Richard Lawley |
First Address | Chicago, IL 60674-0001 |
Second Address | Bloomingdale, IL 60108-2215 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/06/2014 |
Last Update Date | 29/10/2021 |