JODY HANNAH LACK

SPRINGFIELD, IL
NPI1235351818
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy208000000X Pediatrics
(Licence: IL  036-122811)
Enumeration Date2007-05-03
Last Update Date2011-01-13
Business Address
-- JODY HANNAH LACK MD
415 N 9TH ST STE 4W64
SPRINGFIELD, IL 62702-5303
Phone number: 217-545-0003
Mailing Address
-- JODY HANNAH LACK MD
PO BOX 19676
SPRINGFIELD, IL 62794-9676
Phone number: 217-545-0003
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