Provider Demographics
NPI:1558653949
Name:DR LUCY DEY DIABETES ENDOCRINOLOGY AND METABOLISM CLINIC PC
Entity Type:Organization
Organization Name:DR LUCY DEY DIABETES ENDOCRINOLOGY AND METABOLISM CLINIC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LUCY
Authorized Official - Middle Name:
Authorized Official - Last Name:DEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:815-714-2240
Mailing Address - Street 1:17525 ORLAND WOODS LN
Mailing Address - Street 2:
Mailing Address - City:ORLAND PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60467-8565
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:202 N HAMMES AVE UNIT C
Practice Address - Street 2:
Practice Address - City:JOLIET
Practice Address - State:IL
Practice Address - Zip Code:60435-8136
Practice Address - Country:US
Practice Address - Phone:815-714-2240
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-04
Last Update Date:2019-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036112067Medicaid
K39566Medicare PIN