Organization
H DEMITRI MEDICAL SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. HARALAMBOS HATZIDIMITRIADIS MD (PRESIDENT)
(773) 658-2300
Entity
Organization
Contact information
Practice address
33 N ADDISON RD, ADDISON, IL 60101-3875
(630) 530-4144
(630) 530-7404
Mailing address
3960 N HARLEM AVE, CHICAGO, IL 60634-2219
(773) 658-2300
(773) 658-2305
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01634343
BLUE CROSS BLUE SHIELD PI
IL
Enumeration date
09/24/2007
Last updated
01/21/2008
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