Healthcare Provider Details

I. General information

NPI: 1508998170
Provider Name (Legal Business Name): SPYROS BAKIS D.C., C.C.S.P.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/09/2007
Last Update Date: 06/11/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16 N PEORIA ST
CHICAGO IL
60607-2609
US

IV. Provider business mailing address

8424 SKOKIE BLVD STE 207
SKOKIE IL
60077-2568
US

V. Phone/Fax

Practice location:
  • Phone: 312-346-9355
  • Fax: 847-470-0368
Mailing address:
  • Phone: 847-470-1177
  • Fax: 847-470-0368

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111NS0005X
TaxonomySports Physician Chiropractor
License Number038-006760
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code111NN0400X
TaxonomyNeurology Chiropractor
License Number038-006760
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: