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General NPI Number Information
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NPI Number | 1972775856
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Entity Type | Organization
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Legal Business Name | ALLAN L LIEFER MD
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Dates
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Enumeration Date | 03/31/2008
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Last Update Date | 03/31/2008
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Provider Practice Location Address
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Address Line | 1650 STATE ST
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City | CHESTER
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State | IL
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Zip | 62233-1001
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Country | US
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Telephone | 618-826-4152
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Fax | 618-826-4210
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Provider Business Mailing Address
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Address Line | PO BOX 150
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City | CHESTER
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State | IL
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Zip | 62233-0150
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Country | US
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Telephone | 618-826-4152
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Fax | 618-826-4210
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Authorized Official
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Title or Position | OWNER
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Name | DR. ALLAN L LIEFER
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Credential | MD
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Telephone | 618-826-4152
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number |
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License Number State |
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