Individual
DR. DIMITRI G. PERROS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
800 AUSTIN ST, SUITE 507, EVANSTON, IL 60202-3439
(847) 864-7760
(847) 864-0984
Mailing address
800 AUSTIN ST, SUITE 507, EVANSTON, IL 60202-3439
(847) 864-7760
(847) 864-0984
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
036-048039
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036048039
—
IL
01
—
131051300
US DEPT OF LABOR
IL
01
—
180009714
RAILROAD MEDICARE
IL
01
—
21608516
BLUECROSS BLUE SHIELD
ID
01
—
4074893
AETNA
IL
Enumeration date
07/31/2006
Last updated
12/16/2010
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