Provider Demographics
NPI:1316144249
Name:MARIA LENTZOU MD SC
Entity type:Organization
Organization Name:MARIA LENTZOU MD SC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:
Authorized Official - Last Name:LENTZOU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:708-671-1500
Mailing Address - Street 1:12050 S HARLEM AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:PALOS HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60463-1470
Mailing Address - Country:US
Mailing Address - Phone:708-671-1500
Mailing Address - Fax:708-671-1535
Practice Address - Street 1:12050 S HARLEM AVE
Practice Address - Street 2:SUITE A
Practice Address - City:PALOS HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60463-1470
Practice Address - Country:US
Practice Address - Phone:708-671-1500
Practice Address - Fax:708-671-1535
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-03
Last Update Date:2010-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty