Individual
DR. ATHENA KOSTIDIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
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
Update your record
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