Organization
E A DEVASSY MD AND ASSOCIATES SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LYNN M SHERRY (OFFICE MANAGER)
(815) 588-3900
Entity
Organization
Contact information
Practice address
16612 W 159TH ST, SUITE 204, LOCKPORT, IL 60441-8006
(815) 588-3900
(815) 588-1414
Mailing address
16612 W 159TH ST, SUITE 204, LOCKPORT, IL 60441-8006
(815) 588-3900
(815) 588-1414
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
036063297
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036063297
—
IL
Enumeration date
08/20/2007
Last updated
03/06/2013
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