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Individual

ELAINE DIANA TSIAKOPOULOS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
APN

Contact information

Practice address
2293 N MAIN ST, CROWN POINT, IN 46307-1854
(219) 755-3385
Mailing address
2293 N MAIN ST, MEDICAL CHI, CROWN POINT, IN 46307-5965

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
209019372
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
$$$$$$$$$
IN
Enumeration date
05/05/2019
Last updated
11/14/2022
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