MEDICARE: DR. THEODOSIOS PATRAS MD

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	207PE0004X	Emergency Medical Services (Emergency Medicine) Physician	036077713	IL
2	207P00000X	Emergency Medicine Physician	036077713	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1376503771
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. THEODOSIOS PATRAS MD

Provider Business Mailing Address
First Line	:	39182 TREASURY CTR
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60694-9000
Country	:	US
Telephone Number	:	630-734-0200
Fax Number	:

Provider Business Practice Location Address
First Line	:	120 N OAK ST
Second Line	:
City	:	HINSDALE
State	:	IL
Zip	:	60521-3829
Country	:	US
Telephone Number	:	630-856-6700
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/28/2006
Last Update Date	:	06/12/2026

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Directions to “ DR. THEODOSIOS PATRAS MD” Practice Location

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