Provider Demographics
NPI:1306031885
Name:DRS. LAMORENA LTD
Entity Type:Organization
Organization Name:DRS. LAMORENA LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT AND TREASURER
Authorized Official - Prefix:DR
Authorized Official - First Name:BIENVENIDO
Authorized Official - Middle Name:TECSON
Authorized Official - Last Name:LAMORENA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:773-626-8833
Mailing Address - Street 1:4909 W DIVISION ST
Mailing Address - Street 2:SUITE 208
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60651-3161
Mailing Address - Country:US
Mailing Address - Phone:773-626-8833
Mailing Address - Fax:773-777-6917
Practice Address - Street 1:5356 W DIVERSEY AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60639-1513
Practice Address - Country:US
Practice Address - Phone:773-777-9400
Practice Address - Fax:773-777-6917
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-07
Last Update Date:2007-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care