MEDICARE: ELIGIJUS P LELIS MD & ASSOCIATES, SC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies

General Provider Information

NPI Number	:	1619205077
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ELIGIJUS P LELIS MD & ASSOCIATES, SC

Provider Business Mailing Address
First Line	:	963 N 129TH INFANTRY DR
Second Line	:	STE 110
City	:	JOLIET
State	:	IL
Zip	:	60435-3103
Country	:	US
Telephone Number	:	815-725-9377
Fax Number	:	815-725-9358

Provider Business Practice Location Address
First Line	:	1870 SILVER CROSS BLVD
Second Line	:	STE 220
City	:	NEW LENOX
State	:	IL
Zip	:	60451-8646
Country	:	US
Telephone Number	:	815-725-9377
Fax Number	:	815-725-9358

Authorized Official
Title or Position	:	OWNER/CEO
Name	:	DR. ELIGIJUS P LELIS
Credential	:	M.D.
Telephone Number	:	815-725-9377

Provider Enumeration Date	:	11/24/2009
Last Update Date	:	03/04/2011

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