Individual
DR. JOHN NICHOLAS TASIOPOULOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1880 W WINCHESTER RD, SUITE 201, LIBERTYVILLE, IL 60048-5341
(847) 247-0187
(847) 247-0487
Mailing address
1880 W WINCHESTER RD, SUITE 201, LIBERTYVILLE, IL 60048-5341
(847) 247-0187
(847) 247-0487
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
207RG0100X
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036-087154
—
IL
01
—
110136967
MEDICARE RAILROAD
IL
01
—
4907305
BLUE CROSS BLUE SHIELD
IL
Enumeration date
02/19/2007
Last updated
12/13/2021
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