Healthcare Provider Details

I. General information

NPI: 1982756292
Provider Name (Legal Business Name): SPIRO SPIROPOULOS D.N.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/17/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1510 W ALGONQUIN RD
PALATINE IL
60067-4771
US

IV. Provider business mailing address

138 SHERWOOD DR
CARY IL
60013-2271
US

V. Phone/Fax

Practice location:
  • Phone: 184-722-1579
  • Fax: 847-221-5822
Mailing address:
  • Phone: 184-751-6388
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License Number
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: