Healthcare Provider Details

I. General information

NPI: 1124039557
Provider Name (Legal Business Name): AUDRIUS V. PLIOPLYS, M.D., S.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/10/2006
Last Update Date: 03/11/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8844 S PLEASANT AVE
CHICAGO IL
60620-5441
US

IV. Provider business mailing address

777 OAKMONT LN SUITE 1600
WESTMONT IL
60559-5511
US

V. Phone/Fax

Practice location:
  • Phone: 708-445-5060
  • Fax: 773-445-0123
Mailing address:
  • Phone: 630-789-2550
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0402X
TaxonomyNeurology with Special Qualifications in Child Neurology Physician
License Number
License Number StateIL

VIII. Authorized Official

Name: AUDRIUS V PLIOPLYS
Title or Position: PRESIDENT OWNER
Credential: MD
Phone: 708-445-5060