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NPI Code Detail

MEDICARE: H DEMITRI MEDICAL SC

MEDICARE: H DEMITRI MEDICAL SC
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
1207R00000XInternal Medicine Physician

General Provider Information

NPI Number : 1811064918
Entity Type Code : Organization
Provider Name (Legal Business Name) : H DEMITRI MEDICAL SC
Provider Business Mailing Address
First Line : 3960 N HARLEM AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60634-2219
Country : US
Telephone Number : 773-658-2300
Fax Number : 773-658-2305
Provider Business Practice Location Address
First Line : 3960 N HARLEM AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60634-2219
Country : US
Telephone Number : 773-658-2300
Fax Number : 773-658-2305
Authorized Official
Title or Position : PRESIDENT
Name : DR. HARALAMBOS HATZIDIMITRIADIS
Credential : MD
Telephone Number : 708-658-2300
Provider Enumeration Date : 11/30/2006
Last Update Date : 08/22/2020

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Directions to “H DEMITRI MEDICAL SC ” Practice Location

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