Provider Demographics
NPI:1346220514
Name:LOHMANN, LAURENS A (MD)
Entity Type:Individual
Prefix:DR
First Name:LAURENS
Middle Name:A
Last Name:LOHMANN
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 1:855 MADISON ST
Mailing Address - Street 2:
Mailing Address - City:OAK PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60302-4420
Mailing Address - Country:US
Mailing Address - Phone:708-492-4077
Mailing Address - Fax:708-386-2839
Practice Address - Street 1:6827 STANLEY AVE
Practice Address - Street 2:
Practice Address - City:BERWYN
Practice Address - State:IL
Practice Address - Zip Code:60402-3287
Practice Address - Country:US
Practice Address - Phone:708-749-4617
Practice Address - Fax:708-749-0094
Is Sole Proprietor?:No
Enumeration Date:2006-01-22
Last Update Date:2013-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036054149207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036054149Medicaid
ILK49014Medicare PIN
C42416Medicare UPIN
ILK49013Medicare PIN
ILK19872Medicare PIN