Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | 016003058 | IL |
Y | 222Z00000X | Podiatrist | 016003058 | IL |
N | 2081S0010X | Sports Medicine | 016003058 | IL |
N | 213ES0000X | Sports Medicine | 016003058 | IL |
N | 213ES0103X | Foot & Ankle Surgery | 016003058 | IL |
NPI | 1467436808 |
---|---|
Provider Name | Dr. George Tsatsos |
First Address | Chicago, IL 60618 |
Second Address | Chicago, IL 60618 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/11/2005 |
Last Update Date | 23/12/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
016003058 | (05) | IL |
T37305 | (02) | IL |