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NPI Code Detail

MEDICARE: LEJDJA BESHKU PA

MEDICARE:   LEJDJA  BESHKU  PA
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
1363A00000XPhysician Assistant0160921NY
2363A00000XPhysician Assistant085006112IL

General Provider Information

NPI Number : 1588917231
Entity Type Code : Individual
Provider Name (Legal Business Name) : LEJDJA BESHKU PA
Provider Business Mailing Address
First Line : 680 N LAKE SHORE DR STE 1000
Second Line :
City : CHICAGO
State : IL
Zip : 60611-8709
Country : US
Telephone Number : 312-695-0665
Fax Number :
Provider Business Practice Location Address
First Line : 680 N LAKE SHORE DR STE 1000
Second Line :
City : CHICAGO
State : IL
Zip : 60611-8709
Country : US
Telephone Number : 312-695-0665
Fax Number : 312-695-6594
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/18/2012
Last Update Date : 03/17/2018

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Directions to “ LEJDJA BESHKU PA” Practice Location

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