Healthcare Provider Details

I. General information

NPI: 1023637113
Provider Name (Legal Business Name): AGATHANGELOS PERIKLES LOUVROS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/09/2020
Last Update Date: 11/04/2025
Certification Date: 11/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 W HIGGINS RD #440
HOFFMAN ESTATES IL
60169-1530
US

IV. Provider business mailing address

2500 W HIGGINS RD #440
HOFFMAN ESTATES IL
60169
US

V. Phone/Fax

Practice location:
  • Phone: 847-839-0400
  • Fax:
Mailing address:
  • Phone: 847-839-0400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number036164873
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: