MEDICARE: DR. ASHLEY SUZANNE LALEKER MD

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	207RI0200X	Infectious Disease Physician	036162594	IL

General Provider Information

NPI Number	:	1417217829
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ASHLEY SUZANNE LALEKER MD

Provider Business Mailing Address
First Line	:	901 MCCLINTOCK DR STE 202
Second Line	:
City	:	BURR RIDGE
State	:	IL
Zip	:	60527-0872
Country	:	US
Telephone Number	:	888-220-6432
Fax Number	:

Provider Business Practice Location Address
First Line	:	2919 W. ADDISON STREET
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60618-7720
Country	:	US
Telephone Number	:	888-220-6432
Fax Number	:

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

Provider Enumeration Date	:	05/18/2012
Last Update Date	:	01/16/2024

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