Individual
GEORGE A GERANIOS
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2603 S 6TH ST, SPRINGFIELD, IL 62703-3807
(217) 528-0307
(217) 528-0034
Mailing address
2603 S 6TH ST, SPRINGFIELD, IL 62703-3807
(217) 528-0307
(217) 528-0034
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
08432150
BC/BS PROVIDER #
IL
Enumeration date
05/19/2006
Last updated
07/09/2007
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