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Individual

DR. ANGELO ANDREW COSTAS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
200 S MICHIGAN AVE, SUITE 805, CHICAGO, IL 60604-2402
(312) 922-3815
(312) 922-3789
Mailing address
200 S MICHIGAN AVE, SUITE 805, CHICAGO, IL 60604-2402
(312) 922-3815
(312) 922-3789

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
036092729
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
036092729
ILL LIC #
IL
05
0360927291
IL
Enumeration date
05/05/2006
Last updated
03/01/2016
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