Individual
DR. HARALAMBOS HATZIDIMITRIADIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3960 N HARLEM AVE, CHICAGO, IL 60634-2219
(773) 658-2300
(773) 658-2305
Mailing address
3960 N HARLEM AVE, CHICAGO, IL 60634-2219
(773) 658-2300
(773) 658-2305
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
036069054
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01634343
BLUE CROSS BLUE SHIELD PI
IL
05
—
036069054
—
IL
Enumeration date
10/19/2006
Last updated
01/21/2008
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