| Dr Julieta Lasala, MD | |
|
17800 Kedzie Ave, Hazel Crest, IL 60429-2029 | |
| (312) 609-0300 | |
| (773) 213-0378 |
| Full Name | Dr Julieta Lasala |
|---|---|
| Gender | Female |
| Speciality | Family Practice |
| Experience | 11 Years |
| Location | 17800 Kedzie Ave, Hazel Crest, Illinois |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043694045 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 125067701 (Louisiana) | Secondary |
| 207Q00000X | Family Medicine | 036-144164 (Illinois) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Advocate Trinity Hospital | Chicago, IL | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Advocate Health And Hospitals Corporation | 7810800935 | 2682 |
| Entity Name | Advocate Health And Hospitals Corporation |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1700824455 PECOS PAC ID: 7810800935 Enrollment ID: O20031106000064 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Julieta Lasala, MD 29373 Network Pl, Chicago, IL 60673-1293 Ph: (847) 390-5900 | Dr Julieta Lasala, MD 17800 Kedzie Ave, Hazel Crest, IL 60429-2029 Ph: (312) 609-0300 |
Neilesh Shah, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 17850 Kedzie Ave, 3200, Hazel Crest, IL 60429 Phone: 708-798-8112 Fax: 708-798-9016 | |
Dr. Amin Yassin, MD Family Medicine Medicare: Medicare Enrolled Practice Location: 17800 Kedzie Ave, Hazel Crest, IL 60429 Phone: 708-799-8000 Fax: 708-213-0144 | |
Aaron James Magana, DO Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 17800 Kedzie Ave, Hazel Crest, IL 60429 Phone: 312-609-0300 Fax: 773-213-0378 |