Healthcare Provider Details

I. General information

NPI: 1477726396
Provider Name (Legal Business Name): SPIROS K. ANALITIS, M.D.,P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/11/2008
Last Update Date: 05/15/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2350 N ROCKTON AVE
ROCKFORD IL
61103-3600
US

IV. Provider business mailing address

1885 N BRAYMORE DR
INVERNESS IL
60010-6406
US

V. Phone/Fax

Practice location:
  • Phone: 815-971-5550
  • Fax:
Mailing address:
  • Phone: 847-382-6042
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282NC0060X
TaxonomyCritical Access Hospital
License Number036069744
License Number StateIL

VIII. Authorized Official

Name: DR. SPIROS K. ANALITIS
Title or Position: PRESIDENT/OWNER
Credential: M.D.
Phone: 847-382-6042