Provider Demographics
NPI:1528045499
Name:CAMRAS, LAWRENCE (MD)
Entity Type:Individual
Prefix:
First Name:LAWRENCE
Middle Name:
Last Name:CAMRAS
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 1:2160 S 1ST AVE
Mailing Address - Street 2:(MCGAW ENT., RM. 47)
Mailing Address - City:MAYWOOD
Mailing Address - State:IL
Mailing Address - Zip Code:60153-3328
Mailing Address - Country:US
Mailing Address - Phone:708-216-5221
Mailing Address - Fax:708-216-0899
Practice Address - Street 1:2160 S 1ST AVE
Practice Address - Street 2:(MCGAW ENT., RM. 47)
Practice Address - City:MAYWOOD
Practice Address - State:IL
Practice Address - Zip Code:60153-3328
Practice Address - Country:US
Practice Address - Phone:708-216-5221
Practice Address - Fax:708-216-0899
Is Sole Proprietor?:No
Enumeration Date:2005-12-30
Last Update Date:2009-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL360539162085N0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085N0700XAllopathic & Osteopathic PhysiciansRadiologyNeuroradiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL36053916Medicaid
ILL99677Medicare ID - Type Unspecified
IL36053916Medicaid
IL203651Medicare ID - Type Unspecified