Individual
STAVROS ORESTIS ALEXOPOULOS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.P.M.
Contact information
Practice address
2740 W FOSTER AVE STE 107, CHICAGO, IL 60625-3543
(773) 561-8100
Mailing address
2740 W FOSTER AVE STE 107, CHICAGO, IL 60625-3543
(773) 561-8100
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
016004298
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
60010812
BLUE SHIELD OF ILLINOIS
IL
Enumeration date
04/13/2007
Last updated
07/08/2007
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