Provider Demographics
NPI:1023199437
Name:MARGOLIES, LAWRENCE NOEL (MD)
Entity Type:Individual
Prefix:DR
First Name:LAWRENCE
Middle Name:NOEL
Last Name:MARGOLIES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:675 W CENTRAL RD
Mailing Address - Street 2:SUITE 100B
Mailing Address - City:ARLINGTON HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60005-2376
Mailing Address - Country:US
Mailing Address - Phone:847-394-4242
Mailing Address - Fax:847-394-4280
Practice Address - Street 1:675 W CENTRAL RD
Practice Address - Street 2:SUITE 100B
Practice Address - City:ARLINGTON HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60005-2376
Practice Address - Country:US
Practice Address - Phone:847-394-4242
Practice Address - Fax:847-394-4280
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
D12201Medicare UPIN
IL457181Medicare ID - Type Unspecified