Provider Demographics
NPI:1144538430
Name:ALLEN, ALFRED LAMEE (MD)
Entity type:Individual
Prefix:DR
First Name:ALFRED
Middle Name:LAMEE
Last Name:ALLEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:ALFRED
Other - Middle Name:LAMEE
Other - Last Name:AMIN SHEHATA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:5201 WILLOW SPRINGS RD STE 180
Mailing Address - Street 2:
Mailing Address - City:LA GRANGE HIGHLANDS
Mailing Address - State:IL
Mailing Address - Zip Code:60525-6506
Mailing Address - Country:US
Mailing Address - Phone:312-972-5024
Mailing Address - Fax:888-445-4214
Practice Address - Street 1:5595 S OAK ST
Practice Address - Street 2:
Practice Address - City:HINSDALE
Practice Address - State:IL
Practice Address - Zip Code:60521-5063
Practice Address - Country:US
Practice Address - Phone:312-972-4437
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-20
Last Update Date:2024-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-132646207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL8779088476OtherMEDICARE
ILF400310767OtherMEDICARE
IL20150720627853Medicaid
ILF100277374OtherMEDICARE
ILF400277380OtherMEDICARE
IL036132646Medicaid