Provider Demographics
NPI:1689650814
Name:LERNER, CYNTHIA J (MD)
Entity Type:Individual
Prefix:DR
First Name:CYNTHIA
Middle Name:J
Last Name:LERNER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:16345 HARLEM AVE
Mailing Address - Street 2:SUITE 1W
Mailing Address - City:TINLEY PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60477-2589
Mailing Address - Country:US
Mailing Address - Phone:708-633-7001
Mailing Address - Fax:708-845-5287
Practice Address - Street 1:16345 HARLEM AVE
Practice Address - Street 2:SUITE 1W
Practice Address - City:TINLEY PARK
Practice Address - State:IL
Practice Address - Zip Code:60477-2589
Practice Address - Country:US
Practice Address - Phone:708-633-7001
Practice Address - Fax:708-845-5287
Is Sole Proprietor?:No
Enumeration Date:2005-12-20
Last Update Date:2020-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036062126207K00000X
IL36062126173000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
No173000000XOther Service ProvidersLegal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036062126Medicaid
IL31603252OtherBLUECROSS BLUESHIELD
D15821Medicare UPIN