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Individual

PHILIP THEODOROPOULOS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
9650 GROSS POINT RD STE 3900, SKOKIE, IL 60076-5085
(847) 570-1700
Mailing address
2650 RIDGE AVE STE 1223, EVANSTON, IL 60201-1700
(847) 570-2040

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
036096989
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
036096989
IL
01
1629966
BCBS IL NIESS
IL
01
1630046
BLUE CROSS BLUE SHIELD OF ILLINOIS
IL
01
7234385
AETNA
IL
01
P00197606
RR RETIREMENT MC
IL
Enumeration date
07/27/2006
Last updated
02/18/2021
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