Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | 036125184 | IL |
Y | 111NI0900X | Internist | 036125184 | IL |
NPI | 1003074519 |
---|---|
Provider Name | Dr. Elias J Koliopoulos |
First Address | Chicago, IL 60674-0001 |
Second Address | Hinsdale, IL 60521 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/05/2008 |
Last Update Date | 08/02/2021 |