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General NPI Number Information
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NPI Number | 1952938748
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Entity Type | Individual
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Provider Name | KONSTANTINOS EFTHIMIOS KANAKIS MD
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Gender | Male
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Dates
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Enumeration Date | 03/24/2020
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Last Update Date | 07/25/2024
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Provider Practice Location Address
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Address Line | 251 E HURON ST
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City | CHICAGO
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State | IL
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Zip | 60611-3055
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Country | US
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Telephone | 312-926-1900
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Fax | 312-926-5500
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Provider Business Mailing Address
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Address Line | 2160 S 1ST AVE
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City | MAYWOOD
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State | IL
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Zip | 60153-3328
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Country | US
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Telephone | 708-216-4533
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207ZP0102X
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Taxonomy Name | Anatomic Pathology & Clinical Pathology Physician
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License Number | 125.075525
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207ZB0001X
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Taxonomy Name | Blood Banking & Transfusion Medicine Physician
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License Number | 036165447
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License Number State | IL
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