Provider Demographics
NPI:1699064824
Name:LANIOSZ, VALERIE (MD, PHD)
Entity type:Individual
Prefix:DR
First Name:VALERIE
Middle Name:
Last Name:LANIOSZ
Suffix:
Gender:F
Credentials:MD, PHD
Other - Prefix:
Other - First Name:VALERIE
Other - Middle Name:
Other - Last Name:ORSHONSKY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:745 S PARK AVENUE
Mailing Address - Street 2:
Mailing Address - City:HINSDALE
Mailing Address - State:IL
Mailing Address - Zip Code:60521
Mailing Address - Country:US
Mailing Address - Phone:507-284-2511
Mailing Address - Fax:
Practice Address - Street 1:8110 S CASS AVENUE
Practice Address - Street 2:
Practice Address - City:DARIEN
Practice Address - State:IL
Practice Address - Zip Code:60561
Practice Address - Country:US
Practice Address - Phone:630-920-1900
Practice Address - Fax:630-920-1901
Is Sole Proprietor?:No
Enumeration Date:2011-03-28
Last Update Date:2018-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036.139570207N00000X
MI4301111148207N00000X
MN106244207N00000X
MN55690207N00000X
IL125.059193207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MNENROLLEDMedicaid
MNENROLLEDMedicaid