Demorest, Stanley David
Demorest, Stanley David is an individual health care provider with primary practice located at 1111 Superior St Suite 304, Melrose Park IL 60160-4138. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Demorest, Stanley David can be contacted via phone (708) 786-7100.Contact Information
Primary practice address
1111 Superior St Suite 304
Melrose Park IL 60160-4138
Phone: (708) 786-7100
Fax: (708) 786-7101
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 036067738 | Illinois |
Profile Details
| NPI number | 1982769071 |
|---|---|
| LBN Legal business name | Demorest, Stanley David |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 27th, 2006 |
| Last updated | Feb 24th, 2017 - about 7 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1982769071 | NPPES |
| Illinois | Other | 1616867 | BLUE CROSS BLUE SHIELD |
| Illinois | MEDICAID | 036067738 | BLUE CROSS BLUE SHIELD |
| Illinois | Other | 714980 | BLUE CROSS BLUE SHIELD |
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