Provider Demographics
NPI:1871759209
Name:HENRY LAHMEYER, MD, SC
Entity type:Organization
Organization Name:HENRY LAHMEYER, MD, SC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:HENRY
Authorized Official - Middle Name:W
Authorized Official - Last Name:LAHMEYER
Authorized Official - Suffix:
Authorized Official - Credentials:MD SC
Authorized Official - Phone:847-446-3531
Mailing Address - Street 1:465 CENTRAL AVE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:NORTHFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60093-3045
Mailing Address - Country:US
Mailing Address - Phone:847-446-3531
Mailing Address - Fax:847-446-3573
Practice Address - Street 1:465 CENTRAL AVE
Practice Address - Street 2:SUITE 201
Practice Address - City:NORTHFIELD
Practice Address - State:IL
Practice Address - Zip Code:60093-3045
Practice Address - Country:US
Practice Address - Phone:847-446-3531
Practice Address - Fax:847-446-3573
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-05
Last Update Date:2008-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036050377261QM0850X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL665032Medicare PIN