Healthcare Provider Details

I. General information

NPI: 1558404251
Provider Name (Legal Business Name): ANGELINE N BELTSOS M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/14/2007
Last Update Date: 02/12/2024
Certification Date: 02/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1455 N MILWAUKEE AVE FL 2
CHICAGO IL
60622-2015
US

IV. Provider business mailing address

1455 N MILWAUKEE AVE FL 2
CHICAGO IL
60622-2015
US

V. Phone/Fax

Practice location:
  • Phone: 773-435-9036
  • Fax: 773-572-9999
Mailing address:
  • Phone: 773-435-9036
  • Fax: 773-572-9999

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VE0102X
TaxonomyReproductive Endocrinology Physician
License Number036-088775
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: