Individual
DR. DIMITRIOS KOTSOPULOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.P.M.
Contact information
Practice address
12400 S HARLEM AVE STE 201, PALOS HEIGHTS, IL 60463-1476
(708) 923-9630
Mailing address
12400 S HARLEM AVE STE 201, PALOS HEIGHTS, IL 60463-1476
(708) 923-9630
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
016-004977
IL
213E00000X
Podiatrist
07000916A
IN
213ES0103X
Foot & Ankle Surgery Podiatrist
016-004977
IL
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
07000916A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01632993
IL BC/BS PROVIDER #
IL
Enumeration date
08/12/2006
Last updated
05/19/2020
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