MEDICARE: YIANNIS LIMCAOCO KATSOGRIDAKIS 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	208000000X	Pediatrics Physician	036109474	IL
2	207PP0204X	Pediatric Emergency Medicine (Emergency Medicine) Physician	036109474	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	:	1578525507
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	YIANNIS LIMCAOCO KATSOGRIDAKIS MD

Provider Business Mailing Address
First Line	:	2300 CHILDRENS PLAZA
Second Line	:	BOX 62 DIVISION OF PEDIATRIC EMERGENCY MEDICINE
City	:	CHICAGO
State	:	IL
Zip	:	60614-3394
Country	:	US
Telephone Number	:	773-880-4280
Fax Number	:	773-880-8267

Provider Business Practice Location Address
First Line	:	2300 CHILDRENS PLAZA
Second Line	:	CHILDRENS MEMORIAL HOSPITAL
City	:	CHICAGO
State	:	IL
Zip	:	60614-3394
Country	:	US
Telephone Number	:	773-880-8245
Fax Number	:	773-880-8267

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

Provider Enumeration Date	:	04/05/2006
Last Update Date	:	03/08/2021

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Directions to “ YIANNIS LIMCAOCO KATSOGRIDAKIS MD” Practice Location

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