Organization
HOSEP H DEYRMENJIAN, MD, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. HOSEP H DEYRMENJIAN M.D. (OWNER)
(847) 855-3150
Entity
Organization
Contact information
Practice address
6440 GRAND AVE, SUITE 205, GURNEE, IL 60031-5257
(847) 855-3150
(847) 855-3143
Mailing address
6440 GRAND AVE, SUITE 205, GURNEE, IL 60031-5257
(847) 855-3150
(847) 855-3143
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
36079535
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
36079535
—
IL
01
—
4920692
BLUE CROSS BLUE SHIELD
IL
Enumeration date
03/27/2008
Last updated
03/27/2008
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