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NPI Code Detail

MEDICARE: SOTIRIOS A VASILOPOULOS M.D.

MEDICARE: SOTIRIOS A VASILOPOULOS M.D.
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
1207RG0100XGastroenterology PhysicianMD439059PA
2207RG0100XGastroenterology Physician70814WI

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
3PENDINGOTHERPARAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
22152337OTHERPABLUE CROSS/BLUE SHIELD
4MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1568432912
Entity Type Code : Individual
Provider Name (Legal Business Name) : SOTIRIOS A VASILOPOULOS M.D.
Provider Business Mailing Address
First Line : PO BOX 735044
Second Line :
City : CHICAGO
State : IL
Zip : 60673-5044
Country : US
Telephone Number : 800-326-2250
Fax Number :
Provider Business Practice Location Address
First Line : 5900 S LAKE DR
Second Line :
City : CUDAHY
State : WI
Zip : 53110-3171
Country : US
Telephone Number : 414-489-4190
Fax Number : 414-489-4015
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/26/2006
Last Update Date : 06/11/2025

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Directions to “ SOTIRIOS A VASILOPOULOS M.D.” Practice Location

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