MEDICARE: DR. ELSY A DEVASSY 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	174400000X	Specialist	036063297	IL

Other Identifiers

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

General Provider Information

NPI Number	:	1417950783
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ELSY A DEVASSY M.D.

Provider Business Mailing Address
First Line	:	16612 W 159TH ST
Second Line	:	SUITE 204
City	:	LOCKPORT
State	:	IL
Zip	:	60441-8006
Country	:	US
Telephone Number	:	815-588-3900
Fax Number	:	815-588-1414

Provider Business Practice Location Address
First Line	:	16612 W 159TH ST
Second Line	:	SUITE 204
City	:	LOCKPORT
State	:	IL
Zip	:	60441-8006
Country	:	US
Telephone Number	:	815-588-3900
Fax Number	:	815-588-1414

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

Provider Enumeration Date	:	05/31/2005
Last Update Date	:	01/22/2014

Similar Medicare Providers

1306039748 — E A DEVASSY MD AND ASSOCIATES SC
Practice Location Address:

16612 W 159TH ST , SUITE 204
LOCKPORT, IL
60441-8006

Practice Phone: 815-588-3900
Practice Fax: 815-588-1414

1407016744 — FAMILY EYECARE OF LOCKPORT INC.
Practice Location Address:

16612 W 159TH ST , SUITE 200
LOCKPORT, IL
60441-8006

Practice Phone: 815-836-3937
Practice Fax: 815-836-3930

1083577035 — MARIAH ESPINELL
Practice Location Address:

1121 MICHAEL ST
LOCKPORT, IL
60441-3321

Practice Phone: 855-832-6727
Practice Fax:

1568467702 — LOCKPORT DENTAL GROUP, LTD
Practice Location Address:

230 E 8TH ST , STE 5
LOCKPORT, IL
60441-3081

Practice Phone: 815-838-6102
Practice Fax: 815-838-6281

1659377844 — DR. JOSEPH P KARCAVICH MD
Practice Location Address:

300 READ ST , STE B
LOCKPORT, IL
60441-3265

Practice Phone: 815-836-8656
Practice Fax: 815-834-1942

1053312280 — JOHN J DYMOWSKI MD
Practice Location Address:

1206 E 9TH ST
LOCKPORT, IL
60441-2404

Practice Phone: 888-693-6437
Practice Fax:

Directions to “ DR. ELSY A DEVASSY M.D.” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.