Healthcare Provider Details

I. General information

NPI: 1043484561
Provider Name (Legal Business Name): IOANNIS PAPAGIANNIS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/15/2008
Last Update Date: 04/06/2026
Certification Date: 04/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

676 N SAINT CLAIR ST STE 701
CHICAGO IL
60611-2996
US

IV. Provider business mailing address

676 N SAINT CLAIR ST STE 701
CHICAGO IL
60611-2996
US

V. Phone/Fax

Practice location:
  • Phone: 312-695-7970
  • Fax: 312-695-4433
Mailing address:
  • Phone: 312-695-7970
  • Fax: 312-695-4433

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number47122
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number036150945
License Number StateIL
# 3
Primary TaxonomyN
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number0437429
License Number StateKS
# 4
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number47122
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: