Individual
MARY THEODOSOPOULOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1409 MADISON ST, EVANSTON, IL 60202-2138
(773) 414-9992
Mailing address
1409 MADISON ST, EVANSTON, IL 60202-2138
(773) 414-9992
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
209.033529
IL
Other
Enumeration date
10/14/2025
Last updated
10/24/2025
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