Healthcare Provider Details

I. General information

NPI: 1932396488
Provider Name (Legal Business Name): GEORGE TSATSOS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/28/2007
Last Update Date: 09/28/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 N YORK RD
ELMHURST IL
60126-5510
US

IV. Provider business mailing address

2220 W BELMONT AVE
CHICAGO IL
60618-6421
US

V. Phone/Fax

Practice location:
  • Phone: 630-530-5757
  • Fax: 630-203-1640
Mailing address:
  • Phone: 773-348-7500
  • Fax: 630-203-1640

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number16003058
License Number StateIL

VIII. Authorized Official

Name: DR. GEORGE TSATSOS
Title or Position: OWNER
Credential: D.P.M.
Phone: 630-530-5757