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Organization

ANGELO TSAKOPOULOS MD SC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
ANGELO G TSAKOPOULOS MD (MD)
(708) 798-9170
Entity
Organization

Contact information

Practice address
19550 GOVERNORS HWY, SUITE 2700, FLOSSMOOR, IL 60422-2125
(708) 798-9170
(708) 798-9173
Mailing address
PO BOX 1149, MATTESON, IL 60443-4149
(708) 747-5850
(708) 747-9991

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036111440
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1639013
BCBSIL GROUP #
IL
Enumeration date
12/17/2007
Last updated
11/25/2009
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