Provider Demographics
NPI:1528020690
Name:AMATO, LAWRENCE (MD)
Entity Type:Individual
Prefix:DR
First Name:LAWRENCE
Middle Name:
Last Name:AMATO
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 1:1170 E BELVIDERE RD STE 202
Mailing Address - Street 2:
Mailing Address - City:GRAYSLAKE
Mailing Address - State:IL
Mailing Address - Zip Code:60030-2076
Mailing Address - Country:US
Mailing Address - Phone:847-566-0300
Mailing Address - Fax:
Practice Address - Street 1:1170 E BELVIDERE RD STE 202
Practice Address - Street 2:
Practice Address - City:GRAYSLAKE
Practice Address - State:IL
Practice Address - Zip Code:60030-2076
Practice Address - Country:US
Practice Address - Phone:847-566-0300
Practice Address - Fax:847-566-2818
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-04
Last Update Date:2021-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036087495207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine