Jody H. Lack, MD
Pediatrics · Springfield, IL
UnclaimedMDNPI 1235351818
- Primary taxonomy
- 208000000X
- Enumerated
- 2007-05-03
- Practice location
- Springfield, IL
- Last NPPES update
- 2011-01-13
State licenses
- IL · Physician · LICENSED PHYSICIAN AND SURGEONActivethrough 2029
- IL · Resident physician · TEMPORARY MEDICAL PERMITInactivethrough 2009
“Listed on NPI record” means the provider reported this license to NPPES; other statuses come from the state board’s public records as of the last import. License numbers are not shown.
Source: CMS National Plan & Provider Enumeration System (NPPES) and state licensing boards. ScrubHub shows name, credential, taxonomy, practice city/state and license status only.