MEDICARE: SPYRO D. ANALYTIS, MDPC

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	207R00000X	Internal Medicine Physician	036078824	IL

General Provider Information

NPI Number	:	1144471772
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SPYRO D. ANALYTIS, MDPC

Provider Business Mailing Address
First Line	:	114 W WAVERLY ST
Second Line	:
City	:	MORRIS
State	:	IL
Zip	:	60450-1422
Country	:	US
Telephone Number	:	815-634-8030
Fax Number	:	815-634-4052

Provider Business Practice Location Address
First Line	:	460 N BROADWAY ST
Second Line	:
City	:	COAL CITY
State	:	IL
Zip	:	60416-1045
Country	:	US
Telephone Number	:	815-634-8030
Fax Number	:	815-634-4052

Authorized Official
Title or Position	:	MDPC
Name	:	DR. SPYRO D ANALYTIS
Credential	:	MD
Telephone Number	:	815-634-8030

Provider Enumeration Date	:	10/01/2008
Last Update Date	:	10/01/2008

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