MEDICARE: DR. FOTIOS ASIMAKOPOULOS 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	207RH0003X	Hematology & Oncology Physician	54874	WI
2	207RH0003X	Hematology & Oncology Physician	A115772	CA

General Provider Information

NPI Number	:	1518134923
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. FOTIOS ASIMAKOPOULOS MD

Provider Business Mailing Address
First Line	:	1725 W HARRISON ST STE 809
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60612-3861
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1520 W HARRISON ST
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60607-3106
Country	:	US
Telephone Number	:	312-942-1671
Fax Number	:

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

Provider Enumeration Date	:	05/14/2008
Last Update Date	:	07/25/2025

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