Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RC0000X | Internist - Cardiovascular Disease | 036100357 | IL |
Y | 207RI0011X | Interventional Cardiology | 036100357 | IL |
NPI | 1013974187 |
---|---|
Provider Name | Dr. Emmanuel Loutrianaks |
First Address | Chicago, IL 60618-1117 |
Second Address | Chicago, IL 60631 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/05/2006 |
Last Update Date | 10/11/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
036100357 | (05) | IL |
I03975 | (02) |