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Individual

CALLIOPE C ANDRICACOU

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
2850 W 95TH ST, #404, EVERGREEN PARK, IL 60805
(708) 423-4000
(708) 423-4097
Mailing address
2850 W 95TH ST, #404, EVERGREEN PARK, IL 60805
(708) 423-4000
(708) 423-4097

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
036058640
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
21608967
BCBS
IL
Enumeration date
08/20/2006
Last updated
09/11/2012
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