Provider Demographics
NPI:1366501132
Name:LERNER, DAVID J (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:J
Last Name:LERNER
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:2650 RIDGE AVE
Mailing Address - Street 2:EVANSTON HOSPITAL
Mailing Address - City:EVANSTON
Mailing Address - State:IL
Mailing Address - Zip Code:60201-1718
Mailing Address - Country:US
Mailing Address - Phone:847-570-1206
Mailing Address - Fax:847-570-1248
Practice Address - Street 1:2550 WAUKEGAN RD
Practice Address - Street 2:SUITE 100
Practice Address - City:GLENVIEW
Practice Address - State:IL
Practice Address - Zip Code:60025-1777
Practice Address - Country:US
Practice Address - Phone:847-729-2541
Practice Address - Fax:847-729-2546
Is Sole Proprietor?:No
Enumeration Date:2006-12-07
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
IL207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILD13930Medicare UPIN