Basic Information
| Provider Information | |||||||||
| NPI: | 1124071139 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | LENTZOU | ||||||||
| FirstName: | MARIA | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 12050 S HARLEM AVENUE, UNIT A | ||||||||
| Address2: | |||||||||
| City: | PALOS HEIGHTS | ||||||||
| State: | IL | ||||||||
| PostalCode: | 604631141 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7086711500 | ||||||||
| FaxNumber: | 7086711535 | ||||||||
| Practice Location | |||||||||
| Address1: | 12050 S HARLEM AVE STE A | ||||||||
| Address2: | |||||||||
| City: | PALOS HEIGHTS | ||||||||
| State: | IL | ||||||||
| PostalCode: | 604632803 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7086711500 | ||||||||
| FaxNumber: | 7086711535 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/19/2006 | ||||||||
| LastUpdateDate: | 07/27/2011 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 036100946 | IL | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.