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General NPI Number Information
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NPI Number | 1538231782
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Entity Type | Organization
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Legal Business Name | THEODORE POLIZOS DPM COMPREHENSIVE PODIATRIC MEDICAL SERVICES, LTD.
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Dates
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Enumeration Date | 11/14/2006
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Last Update Date | 03/09/2010
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Provider Practice Location Address
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Address Line | 2740 W FOSTER AVE SUITE #205
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City | CHICAGO
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State | IL
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Zip | 60625-3500
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Country | US
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Telephone | 773-271-9050
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Fax | 773-271-9051
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Provider Business Mailing Address
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Address Line | PO BOX 95727
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City | HOFFMAN ESTATES
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State | IL
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Zip | 60195-0727
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Country | US
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Telephone | 773-271-9050
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Fax | 773-271-9051
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Authorized Official
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Title or Position | PHYSICIAN/OWNER
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Name | DR. THEODORE POLIZOS
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Credential | DPM
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Telephone | 773-271-9050
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number |
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License Number State |
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