Provider Demographics
NPI:1972775856
Name:ALLAN L LIEFER MD
Entity type:Organization
Organization Name:ALLAN L LIEFER MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ALLAN
Authorized Official - Middle Name:L
Authorized Official - Last Name:LIEFER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:618-826-4152
Mailing Address - Street 1:PO BOX 150
Mailing Address - Street 2:
Mailing Address - City:CHESTER
Mailing Address - State:IL
Mailing Address - Zip Code:62233-0150
Mailing Address - Country:US
Mailing Address - Phone:618-826-4152
Mailing Address - Fax:618-826-4210
Practice Address - Street 1:1650 STATE ST
Practice Address - Street 2:
Practice Address - City:CHESTER
Practice Address - State:IL
Practice Address - Zip Code:62233-1001
Practice Address - Country:US
Practice Address - Phone:618-826-4152
Practice Address - Fax:618-826-4210
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-31
Last Update Date:2008-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty