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NPI Code Detail

MEDICARE: DR. JOHN NICHOLAS KIRIKLAKIS M.D.

MEDICARE: DR. JOHN NICHOLAS KIRIKLAKIS 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
1207R00000XInternal Medicine Physician036-100938IL

Other Identifiers

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

General Provider Information

NPI Number : 1730189713
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JOHN NICHOLAS KIRIKLAKIS M.D.
Provider Business Mailing Address
First Line : 2650 RIDGE AVE
Second Line :
City : EVANSTON
State : IL
Zip : 60201-1718
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 225 N MILWAUKEE AVE
Second Line :
City : VERNON HILLS
State : IL
Zip : 60061-4304
Country : US
Telephone Number : 847-941-7600
Fax Number : 847-941-7698
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/29/2005
Last Update Date : 02/16/2021

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