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Organization

H DEMITRI MEDICAL SC

Active
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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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