Organization
DIMITRIOS KOTSOPULOS, D.P.M., P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DIMITRIOS KOTSOPULOS D.P.M. (PRESIDENT, OWNER)
(708) 923-9630
Entity
Organization
Contact information
Practice address
12400 S HARLEM AVE STE 201, PALOS HEIGHTS, IL 60463-1476
(708) 923-9630
Mailing address
12400 S HARLEM AVE STE 201, PALOS HEIGHTS, IL 60463-1476
(708) 923-9630
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01637213
BC/BS OF IL GROUP #
IL
Enumeration date
11/13/2006
Last updated
05/19/2020
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