Provider Demographics
NPI:1417967829
Name:HASPEL, LAWRENCE U (DO)
Entity type:Individual
Prefix:
First Name:LAWRENCE
Middle Name:U
Last Name:HASPEL
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3615 PARK DR
Mailing Address - Street 2:SUITE 203
Mailing Address - City:OLYMPIA FIELDS
Mailing Address - State:IL
Mailing Address - Zip Code:60461-1186
Mailing Address - Country:US
Mailing Address - Phone:708-748-9800
Mailing Address - Fax:
Practice Address - Street 1:3800 W 203RD ST
Practice Address - Street 2:STE 202
Practice Address - City:OLYMPIA FIELDS
Practice Address - State:IL
Practice Address - Zip Code:60461-1184
Practice Address - Country:US
Practice Address - Phone:708-747-0461
Practice Address - Fax:708-747-4704
Is Sole Proprietor?:No
Enumeration Date:2006-08-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILC41346Medicare UPIN
IL458603Medicare ID - Type Unspecified
IL458500Medicare ID - Type Unspecified