Individual
DR. THERESA J LIE-NEMETH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1401 S. CALIFORNIA BLVD., CHICAGO, IL 60608
(773) 522-5857
(773) 522-5886
Mailing address
1401 S. CALIFORNIA BLVD., CHICAGO, IL 60608
(773) 522-5857
(773) 522-5886
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
036109913
IL
208100000X
Physical Medicine & Rehabilitation Physician
220616
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2077671
—
MA
01
—
469219
TUFTS HEALTH PLAN
MA
01
—
J27613
BCBS MA
MA
Enumeration date
10/28/2005
Last updated
07/30/2010
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