Individual
DR. CHRISTOPHER THEODORE KARDASIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
17850 KEDZIE AVE, DOCTORS PAVILION SUITE 1200, HAZEL CREST, IL 60429-2058
(708) 799-3720
(708) 799-3733
Mailing address
17850 KEDZIE AVE, DOCTORS PAVILION SUITE 1200, HAZEL CREST, IL 60429-2058
(708) 799-3720
(708) 799-3733
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
036096219
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01620286
BCBS PROVIDER NUMBER
IL
05
—
036096219
—
IL
01
—
180043027
RR MEDICARE PROVIDER NO.
IL
01
—
30022730030338
ADVOCATE PROVIDER NUMBER
IL
Enumeration date
01/12/2007
Last updated
07/09/2007
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