Provider Demographics
NPI:1932714003
Name:LAWRENCE, ANTHONIA N
Entity Type:Individual
Prefix:
First Name:ANTHONIA
Middle Name:N
Last Name:LAWRENCE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10124 PEACH PKWY UNIT N106
Mailing Address - Street 2:
Mailing Address - City:SKOKIE
Mailing Address - State:IL
Mailing Address - Zip Code:60076-4216
Mailing Address - Country:US
Mailing Address - Phone:773-430-4173
Mailing Address - Fax:
Practice Address - Street 1:10124 PEACH PKWY UNIT N106
Practice Address - Street 2:
Practice Address - City:SKOKIE
Practice Address - State:IL
Practice Address - Zip Code:60076-4216
Practice Address - Country:US
Practice Address - Phone:773-430-4173
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-15
Last Update Date:2020-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL194007705227900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes227900000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Registered