MEDICARE: AUDRIUS V. PLIOPLYS, M.D., S.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084N0402X	Neurology with Special Qualifications in Child Neurology Physician		IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2232936	OTHER	IL	BCBS PROVIDER ID

General Provider Information

NPI Number	:	1124039557
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AUDRIUS V. PLIOPLYS, M.D., S.C.

Provider Business Mailing Address
First Line	:	777 OAKMONT LN
Second Line	:	SUITE 1600
City	:	WESTMONT
State	:	IL
Zip	:	60559-5511
Country	:	US
Telephone Number	:	630-789-2550
Fax Number	:

Provider Business Practice Location Address
First Line	:	8844 S PLEASANT AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60620-5441
Country	:	US
Telephone Number	:	708-445-5060
Fax Number	:	773-445-0123

Authorized Official
Title or Position	:	PRESIDENT OWNER
Name	:	AUDRIUS V PLIOPLYS
Credential	:	MD
Telephone Number	:	708-445-5060

Provider Enumeration Date	:	08/10/2006
Last Update Date	:	03/11/2008

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