Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dr. Lawrence Thomas Mollo, MD

Individual provider Internal Medicine Physician · NPI 1508122334

Dr. Lawrence Thomas Mollo, MD is a Pediatric Medicine in Champlin, Minnesota. Qualified in 2012, 14 years ago. Practices with Park Nicollet Clinic, a 1,773-clinician group, works from 2 locations, accepts Medicare assignment and offers telehealth. Licensed in Illinois and Minnesota.

Years since qualifying
14
Licensed in
IL, MN
In the registry since
2012
Specialties on file
4
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

12142 Business Park Blvd N
Champlin, MN 55316-4525
Phone: (952) 977-0500
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 2160 S 1st Ave, Maywood, IL 60153-3328 — (708) 216-8757

Specialties & licences

Pediatrics Physician (primary) Taxonomy 208000000X · Licence 62157 (MN)
Internal Medicine Physician Taxonomy 207R00000X · Licence 62157 (MN)
Internal Medicine Physician Taxonomy 207R00000X · Licence 125061609 (IL)
Pediatrics Physician Taxonomy 208000000X · Licence 125061609 (IL)

Record details

NPI number1508122334
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorYes
NPI enumeratedApril 5, 2012
Last updated in NPPESJuly 21, 2022
Mailing address2160 S 1st Ave, Rm 7609, Maywood, IL 60153-3328

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPEDIATRIC MEDICINE
Medical schoolOTHER
Graduated 2012 (14 years in practice)
Group practice Park Nicollet Clinic — 1773 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

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