MEDICARE: DR. DEAN T. VELIS M.D.

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	207R00000X	Internal Medicine Physician	036085777	IL

General Provider Information

NPI Number	:	1164580882
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DEAN T. VELIS M.D.

Provider Business Mailing Address
First Line	:	600 W LAKE COOK RD STE 110
Second Line	:
City	:	BUFFALO GROVE
State	:	IL
Zip	:	60089-2085
Country	:	US
Telephone Number	:	847-459-6495
Fax Number	:	847-459-7929

Provider Business Practice Location Address
First Line	:	1430 N ARLINGTON HEIGHTS ROAD
Second Line	:	SUITE 105
City	:	ARLINGTON HEIGHTS
State	:	IL
Zip	:	60004-4823
Country	:	US
Telephone Number	:	847-259-8226
Fax Number	:	847-392-5260

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/05/2006
Last Update Date	:	01/08/2016

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