Healthcare Provider Details

I. General information

NPI: 1538231782
Provider Name (Legal Business Name): THEODORE POLIZOS DPM COMPREHENSIVE PODIATRIC MEDICAL SERVICES, LTD.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/14/2006
Last Update Date: 08/20/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2740 W FOSTER AVE SUITE #205
CHICAGO IL
60625-3500
US

IV. Provider business mailing address

PO BOX 95727
HOFFMAN ESTATES IL
60195-0727
US

V. Phone/Fax

Practice location:
  • Phone: 773-271-9050
  • Fax: 773-271-9051
Mailing address:
  • Phone: 773-271-9050
  • Fax: 773-271-9051

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QP1100X
TaxonomyPodiatric Clinic/Center
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number
License Number StateNULL

VIII. Authorized Official

Name: DR. THEODORE POLIZOS
Title or Position: PHYSICIAN/OWNER
Credential: DPM
Phone: 773-271-9050