Individual
DR. GEORGE THOMAS AMPALLOOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1044 N MOZART ST, SUITE 402, CHICAGO, IL 60622-2789
(773) 292-4501
(773) 292-2613
Mailing address
1044 N MOZART ST, SUITE 402, CHICAGO, IL 60622-2789
(773) 292-4501
(773) 292-2613
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
036-105483
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036105483
—
IL
Enumeration date
08/03/2006
Last updated
06/15/2016
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