Individual
GEOFFREY TSARAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1340 CHARLES ST STE 404, ROCKFORD, IL 61104-2200
(779) 696-1890
(779) 696-2410
Mailing address
PO BOX 78866, MILWAUKEE, WI 53278-8866
(779) 696-7150
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
036126289
IL
207RI0200X
Infectious Disease Physician
103894
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036126289
—
IL
05
—
ENROLLED
—
MN
01
—
P00746355
MEDICARE, RAILROAD
MN
Enumeration date
06/16/2008
Last updated
03/12/2021
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