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Individual
STEPHEN H DOUNDOULAKIS
Active
Individual
STEPHEN H DOUNDOULAKIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
2085B0100X
Body Imaging Physician
036072842
IL
2085N0700X
Neuroradiology Physician
Primary
036072842
IL
2085N0904X
Nuclear Radiology Physician
036072842
IL
2085P0229X
Pediatric Radiology Physician
036072842
IL
2085R0202X
Diagnostic Radiology Physician
036072842
IL
2085R0204X
Vascular & Interventional Radiology Physician
036072842
IL
2085U0001X
Diagnostic Ultrasound Physician
036072842
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0001619902
BLUE CROSS BLUE SHIELD-IL
IL
05
—
036072842-3
—
IL
Enumeration date
07/17/2006
Last updated
05/09/2013
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