Organization
MEN'S CLINIC, PLLC
Active
Organization
MEN'S CLINIC, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALEXANDER PAZIOTOPOULOS MD (OWNER)
(844) 734-3678
Entity
Organization
Contact information
Practice address
2700 S RIVER RD STE 309, DES PLAINES, IL 60018-4101
(312) 789-4450
Mailing address
2700 S RIVER RD STE 309, DES PLAINES, IL 60018-4101
(312) 789-4450
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
036.134622
STATE OF IL LICENSE
IL
Enumeration date
03/18/2020
Last updated
03/18/2020
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