Individual
DR. WILLIAM WESLEY THEODOROU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1653 W CONGRESS PKWY, CHICAGO, IL 60612-3833
(312) 942-5495
Mailing address
1653 W CONGRESS PKWY, CHICAGO, IL 60612-3833
(312) 942-5495
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
036.130614
IL
2085R0202X
Diagnostic Radiology Physician
125.055740
IL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/15/2008
Last updated
02/04/2013
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