Provider Demographics
NPI:1346655487
Name:DUCHARME-CREVIER, LAURENCE
Entity Type:Individual
Prefix:
First Name:LAURENCE
Middle Name:
Last Name:DUCHARME-CREVIER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:225 E. CHICAGO AVENUE, BOX 51 - DIVISION OF NEUROLOGY
Mailing Address - Street 2:ANN & ROBERT H. LURIE CHILDREN'S HOSPITAL OF CHICAGO
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-2605
Mailing Address - Country:US
Mailing Address - Phone:312-227-4486
Mailing Address - Fax:
Practice Address - Street 1:225 E. CHICAGO AVENUE, BOX 51 - DIVISION OF NEUROLOGY
Practice Address - Street 2:ANN & ROBERT H. LURIE CHILDREN'S HOSPITAL OF CHICAGO
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-2605
Practice Address - Country:US
Practice Address - Phone:312-227-4486
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-27
Last Update Date:2015-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program