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Individual

THERESA KRISTOPAITIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
2160 S 1ST AVE, (EMS BLDG., R. 2209), MAYWOOD, IL 60153
(708) 216-3250
(708) 216-2620
Mailing address
2160 S 1ST AVE, (EMS BLDG., R. 2209), MAYWOOD, IL 60153
(708) 216-3250
(708) 216-2620

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
36092517
IL
208M00000X
Hospitalist Physician
Primary
036092517
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
36092517
IL
Enumeration date
02/22/2006
Last updated
11/11/2021
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