Individual ProviderTerrence DemosRadiologyAllopathic & Osteopathic PhysiciansPractice Address2160 S First Ave, Mcgaw Ent., Rm. 47, Maywood, IL 60153(708) 216-5221PECOS EnrollmentBased on the most recent information from CMS, provider Terrence Demos is legally eligible to order and refer claims for DME and PMD services only.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records 7 days ago.Profile DetailsProvider ID1912984881Provider TypeIndividualFull NameDemos, TerrenceCredentialMDGenderMaleSole ProprietorNoEnumeration Date12/30/2005Last Updated9/2/2009Contact InformationPractice LocationPractice Address2160 S First Ave, Mcgaw Ent., Rm. 47, Maywood, IL 60153Phone(708) 216-5221Fax(707) 216-0899Mailing LocationMailing Address2160 S First Ave, Mcgaw Ent., Rm. 47, Maywood, IL 60153Phone(708) 216-5221Fax(707) 216-0899Provider TaxonomiesCodeDescriptionLicenseCode2085R0202XPrimaryDescriptionRadiologyAllopathic & Osteopathic PhysiciansLicense36039106IllinoisProvider IdentifiersIDDescriptionIssuerID36039106DescriptionMedicaidIssuerUnlistedIllinois