Individual
TELLY PSARADELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2850 S WABASH AVE, SUITE 100, CHICAGO, IL 60616-2955
(312) 842-4600
(312) 842-8694
Mailing address
2850 S WABASH AVE, SUITE 100, CHICAGO, IL 60616-2955
(312) 842-4600
(312) 842-8694
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
036-113086
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036113086
—
IL
01
—
CF2064
RAILROAD GROUP
IL
01
—
P00252879
RAILROAD MEDICARE
—
Enumeration date
01/30/2006
Last updated
04/24/2009
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