Dr. Lee Michael Ceresa
Endodontist
1601 4th St
Peru
, Illinois 61354-3507
Dr. Lee Michael Ceresa
Endodontist
1601 4th St
Peru
, Illinois 61354-3507
(815) 220-1479
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About
Features
Specialties
- Endodontist
Languages spoken
- English
Location
First Address
- Dr. Lee Michael Ceresa
- 1601 4th St
- Peru, IL
- Zip : 61354-3507
- Fax : (815) 220-1479
- Phone : (815) 224-3636
Second Address
- Dr. Lee Michael Ceresa
- 1601 4th St
- Peru, IL
- Zip : 61354-3507
- Fax : (815) 220-1479
- Phone : (815) 224-3636
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 1223E0200X | Endodontist | 021001935 | IL |
National Provider Identifier
| NPI | 1063513117 |
|---|---|
| Provider Name | Dr. Lee Michael Ceresa |
| First Address | Peru, IL 61354-3507 |
| Second Address | Peru, IL 61354-3507 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 25/09/2006 |
| Last Update Date | 30/09/2014 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.