Provider Demographics
NPI:1144257981
Name:LAWRENCE, CHRISTINE (DPM)
Entity type:Individual
Prefix:DR
First Name:CHRISTINE
Middle Name:
Last Name:LAWRENCE
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:CHISTINE
Other - Middle Name:
Other - Last Name:COZZI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPM
Mailing Address - Street 1:1516 E 87TH ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60619-6525
Mailing Address - Country:US
Mailing Address - Phone:773-978-7000
Mailing Address - Fax:773-978-4606
Practice Address - Street 1:1516 E 87TH ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60619-6525
Practice Address - Country:US
Practice Address - Phone:773-978-7000
Practice Address - Fax:773-978-4606
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2007-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILP00097895OtherRAILROAD MEDICARE
IL1633823OtherBCBS
ILP00097895OtherRAILROAD MEDICARE
ILU81135Medicare UPIN
IL1633823OtherBCBS