Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 47122 | TN |
N | 111NI0900X | Internist | 47122 | TN |
Y | 207RE0101X | Endocrinologist (Diabetes Doctor) | 036150945 | IL |
N | 207RE0101X | Endocrinologist (Diabetes Doctor) | 0437429 | KS |
N | 207RE0101X | Endocrinologist (Diabetes Doctor) | 47122 | TN |
NPI | 1043484561 |
---|---|
Provider Name | Dr. Ioannis Papagiannis |
First Address | Chicago, IL 60611-5966 |
Second Address | Chicago, IL 60611-5966 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/04/2008 |
Last Update Date | 02/03/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
036150945 | STATE MEDICAL LICENSE (01) | IL |