Organization
DEMOREST CONSUTANTS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. S DAVID DEMOREST M.D. (PRESIDENT)
(440) 279-0599
Entity
Organization
Contact information
Practice address
7255 W GRAND AVE, ELMWOOD PARK, IL 60707-2028
(440) 279-0599
(440) 279-0593
Mailing address
7255 W GRAND AVE, ELMWOOD PARK, IL 60707-2028
(440) 279-0599
(440) 279-0593
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036067738
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PENDING
—
IL
Enumeration date
03/14/2009
Last updated
03/14/2009
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