Individual
DR. THOMAS D PATRIANAKOS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
5683 N MILWAUKEE AVE, CHICAGO, IL 60646-6220
(773) 792-2020
(773) 792-2025
Mailing address
5683 N MILWAUKEE AVE, CHICAGO, IL 60646-6220
(773) 792-2020
(773) 792-2025
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
036-113316
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0001637629
BLUE CROSS BLUE SHIELD
IL
05
—
036113316
—
IL
Enumeration date
07/16/2006
Last updated
04/28/2021
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