Basic Information
Provider Information
NPI: 1861990731
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: LALONDE
FirstName: SEBASTIEN
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: MD,CM FRCS(C)
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1301 S KOKE MILL RD
Address2:  
City: SPRINGFIELD
State: IL
PostalCode: 627119252
CountryCode: US
TelephoneNumber: 2175479100
FaxNumber: 2175479236
Practice Location
Address1: 1301 S KOKE MILL RD
Address2:  
City: SPRINGFIELD
State: IL
PostalCode: 627119252
CountryCode: US
TelephoneNumber: 2175479100
FaxNumber: 2175479236
Other Information
ProviderEnumerationDate: 01/25/2018
LastUpdateDate: 11/02/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 11/02/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207XS0106X2017035183MON Allopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery
207XS0106X036157163ILY Allopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery

No ID Information.


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