Provider Demographics
NPI:1154600104
Name:LANEY, ERNEST JOHN IV (MD)
Entity type:Individual
Prefix:DR
First Name:ERNEST
Middle Name:JOHN
Last Name:LANEY
Suffix:IV
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:31 S. ARLINGTON HEIGHTS ROAD
Mailing Address - Street 2:
Mailing Address - City:ELK GROVE VILLAGE
Mailing Address - State:IL
Mailing Address - Zip Code:60007
Mailing Address - Country:US
Mailing Address - Phone:847-439-2315
Mailing Address - Fax:847-439-3935
Practice Address - Street 1:31 S. ARLINGTON HEIGHTS ROAD
Practice Address - Street 2:
Practice Address - City:ELK GROVE VILLAGE
Practice Address - State:IL
Practice Address - Zip Code:60007
Practice Address - Country:US
Practice Address - Phone:847-439-2315
Practice Address - Fax:847-439-3935
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-09
Last Update Date:2024-01-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL0361356662085R0202X
TXS87282085R0202X
ND197672085N0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085N0700XAllopathic & Osteopathic PhysiciansRadiologyNeuroradiology
No2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology