Basic Information
| Provider Information | |||||||||
| NPI: | 1699877175 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | LORBER | ||||||||
| FirstName: | DAVID | ||||||||
| MiddleName: | A | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 9711 SKOKIE BLVD | ||||||||
| Address2: | SUITE J | ||||||||
| City: | SKOKIE | ||||||||
| State: | IL | ||||||||
| PostalCode: | 600771384 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8476759711 | ||||||||
| FaxNumber: | 8476759714 | ||||||||
| Practice Location | |||||||||
| Address1: | 9711 SKOKIE BLVD | ||||||||
| Address2: | SUITE J | ||||||||
| City: | SKOKIE | ||||||||
| State: | IL | ||||||||
| PostalCode: | 600771384 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8476759711 | ||||||||
| FaxNumber: | 8476759714 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/04/2006 | ||||||||
| LastUpdateDate: | 09/12/2012 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207N00000X | 036-066262 | IL | Y | Allopathic & Osteopathic Physicians | Dermatology |
No ID Information.