Individual
DR. ATHENA KOSTIDIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2160 S 1ST AVE, (17W740 22ND STREET, OAKBROOK TERRACE, IL. 60181), MAYWOOD, IL 60153
(630) 627-7399
(630) 627-7079
Mailing address
2160 S 1ST AVE, (17W740 22ND STREET, OAKBROOK TERRACE, IL. 60181), MAYWOOD, IL 60153
(630) 627-7399
(630) 627-7079
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
36113445
IL
2084N0600X
Clinical Neurophysiology Physician
36113445
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
36113445
—
IL
Enumeration date
01/23/2006
Last updated
10/13/2009
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