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NPI Code Detail

MEDICARE: LELA DEMETER MD PC

MEDICARE: LELA DEMETER MD PC
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
1207R00000XInternal Medicine Physician036098873IL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1821135948
Entity Type Code : Organization
Provider Name (Legal Business Name) : LELA DEMETER MD PC
Provider Business Mailing Address
First Line : 11824 SOUTHWEST HWY STE 130
Second Line :
City : PALOS HEIGHTS
State : IL
Zip : 60463-2658
Country : US
Telephone Number : 708-923-1900
Fax Number : 708-923-1119
Provider Business Practice Location Address
First Line : 11824 SOUTHWEST HWY STE 130
Second Line :
City : PALOS HEIGHTS
State : IL
Zip : 60463-2658
Country : US
Telephone Number : 708-923-1900
Fax Number : 708-923-1119
Authorized Official
Title or Position : PRESIDENT
Name : LELA DEMETER
Credential : MD
Telephone Number : 708-479-6522
Provider Enumeration Date : 01/30/2007
Last Update Date : 05/08/2008

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