Provider Demographics
NPI:1053549303
Name:DILEEP-ANSAL, LALITHA (MD)
Entity type:Individual
Prefix:DR
First Name:LALITHA
Middle Name:
Last Name:DILEEP-ANSAL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:LALITHA
Other - Middle Name:
Other - Last Name:DILEEP
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:172 SCHILLER ST
Mailing Address - Street 2:
Mailing Address - City:ELMHURST
Mailing Address - State:IL
Mailing Address - Zip Code:60126
Mailing Address - Country:US
Mailing Address - Phone:331-221-6377
Mailing Address - Fax:331-221-2706
Practice Address - Street 1:155 E BRUSH HILL RD
Practice Address - Street 2:
Practice Address - City:ELMHURST
Practice Address - State:IL
Practice Address - Zip Code:60126
Practice Address - Country:US
Practice Address - Phone:331-221-8952
Practice Address - Fax:331-221-3782
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-25
Last Update Date:2018-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL125055636207R00000X
IL036129155207R00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine