Provider Demographics
NPI:1326492414
Name:LAU, DENNY (DO)
Entity Type:Individual
Prefix:
First Name:DENNY
Middle Name:
Last Name:LAU
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1102 W ARGYLE ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60640-3610
Mailing Address - Country:US
Mailing Address - Phone:773-394-2888
Mailing Address - Fax:773-394-2889
Practice Address - Street 1:1102 W ARGYLE ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60640-3610
Practice Address - Country:US
Practice Address - Phone:773-394-2888
Practice Address - Fax:773-394-2889
Is Sole Proprietor?:No
Enumeration Date:2016-04-15
Last Update Date:2020-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036148362207Q00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program