Provider Demographics
NPI:1699759282
Name:PIELET, ALLEN M (MD)
Entity type:Individual
Prefix:
First Name:ALLEN
Middle Name:M
Last Name:PIELET
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Gender:M
Credentials:MD
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Mailing Address - Street 1:6701 159TH ST
Mailing Address - Street 2:SUITE C
Mailing Address - City:TINLEY PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60477-1758
Mailing Address - Country:US
Mailing Address - Phone:708-342-6240
Mailing Address - Fax:708-342-6250
Practice Address - Street 1:6701 159TH ST
Practice Address - Street 2:SUITE C
Practice Address - City:TINLEY PARK
Practice Address - State:IL
Practice Address - Zip Code:60477-1758
Practice Address - Country:US
Practice Address - Phone:708-342-6240
Practice Address - Fax:708-342-6250
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-06
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
IL207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILL79475Medicare ID - Type Unspecified
C50904Medicare UPIN