Healthcare Provider Details

I. General information

NPI: 1972657666
Provider Name (Legal Business Name): GEORGE SKARPATHIOTIS, M.D., S.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/22/2007
Last Update Date: 02/26/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7110 W 127TH ST
PALOS HEIGHTS IL
60463-1571
US

IV. Provider business mailing address

7110 W 127TH ST
PALOS HEIGHTS IL
60463-1571
US

V. Phone/Fax

Practice location:
  • Phone: 708-923-6300
  • Fax: 708-923-6303
Mailing address:
  • Phone: 708-923-6300
  • Fax: 708-923-6303

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number036-070269
License Number StateIL

VIII. Authorized Official

Name: DR. GEORGE I. SKARPATHIOTIS
Title or Position: MEDICAL DIRECTOR
Credential: M.D.
Phone: 708-923-6300