Provider Demographics
NPI:1346833753
Name:DR. LAVINIA L MYERS, PC
Entity type:Organization
Organization Name:DR. LAVINIA L MYERS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LAVINIA
Authorized Official - Middle Name:
Authorized Official - Last Name:MYERS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:708-860-7290
Mailing Address - Street 1:16W281 83RD ST STE B
Mailing Address - Street 2:
Mailing Address - City:BURR RIDGE
Mailing Address - State:IL
Mailing Address - Zip Code:60527-7967
Mailing Address - Country:US
Mailing Address - Phone:630-581-7798
Mailing Address - Fax:630-581-7799
Practice Address - Street 1:16W281 83RD ST STE B
Practice Address - Street 2:
Practice Address - City:BURR RIDGE
Practice Address - State:IL
Practice Address - Zip Code:60527-7967
Practice Address - Country:US
Practice Address - Phone:630-581-7798
Practice Address - Fax:630-581-7799
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-17
Last Update Date:2021-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty