Provider Demographics
NPI:1457766545
Name:DR. ELIZABETH LAWLER, M.D., S.C.
Entity Type:Organization
Organization Name:DR. ELIZABETH LAWLER, M.D., S.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:
Authorized Official - Last Name:LAWLER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:618-967-7889
Mailing Address - Street 1:1129 N CARBON ST
Mailing Address - Street 2:P.O. BOX 1733
Mailing Address - City:MARION
Mailing Address - State:IL
Mailing Address - Zip Code:62959-1068
Mailing Address - Country:US
Mailing Address - Phone:618-967-7889
Mailing Address - Fax:
Practice Address - Street 1:1129 N CARBON ST
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:IL
Practice Address - Zip Code:62959-1068
Practice Address - Country:US
Practice Address - Phone:618-967-7889
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-26
Last Update Date:2014-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036135003207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Multi-Specialty