Individual
DR. CHRISTOS S GIANNOULIAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D./M.S.
Contact information
Practice address
1200 S YORK RD, SUITE 4190, ELMHURST, IL 60126-5626
(630) 782-1174
Mailing address
1200 S YORK RD, SUITE 4190, ELMHURST, IL 60126-5626
(630) 782-1174
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
036104649
IL
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
036104649
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
02232584
BLUE CROSS BLUE SHIELD
IL
05
—
036104649
—
IL
01
—
610189800
DEPT OF LABOR
IL
01
—
P00192973
RAILROAD MEDICARE
IL
Enumeration date
05/08/2006
Last updated
04/30/2015
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