Organization
G & T ORTHOPAEDICS AND SPORTS MEDICINE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTOS GIANNOULIAS MD (PRESIDENT)
(630) 782-1174
Entity
Organization
Contact information
Practice address
1200 S YORK RD, SUITE 4190, ELMHURST, IL 60126-5626
(630) 782-1174
(773) 275-2443
Mailing address
1200 S YORK RD, SUITE 4190, ELMHURST, IL 60126-5626
(630) 782-1174
(773) 275-2443
Taxonomy
Speciality
Code
Description
License number
State
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
02232584
BCBS GROUP
IL
01
—
610189700
DEPT OF LABOR
IL
01
—
DC2601
RAILROAD MEDICARE GROUP
IL
Enumeration date
06/28/2006
Last updated
06/10/2015
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