Provider Demographics
NPI:1518942671
Name:VEITS, JOAN (MD)
Entity Type:Individual
Prefix:DR
First Name:JOAN
Middle Name:
Last Name:VEITS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:505 N LAKE SHORE DR
Mailing Address - Street 2:UNIT 3308
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-3427
Mailing Address - Country:US
Mailing Address - Phone:312-670-3667
Mailing Address - Fax:
Practice Address - Street 1:1111 SUPERIOR ST
Practice Address - Street 2:SUITE 207
Practice Address - City:MELROSE PARK
Practice Address - State:IL
Practice Address - Zip Code:60160-4138
Practice Address - Country:US
Practice Address - Phone:708-938-7580
Practice Address - Fax:708-938-7381
Is Sole Proprietor?:No
Enumeration Date:2005-12-13
Last Update Date:2007-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036098635 / 01Medicaid
ILI 19700Medicare UPIN