MEDICARE: DR. PANOREA TSILIMIGRAS DDS

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	1223G0001X	General Practice Dentistry		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	:	1851417265
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PANOREA TSILIMIGRAS DDS

Provider Business Mailing Address
First Line	:	25 E WASHINGTON ST
Second Line	:	SUITE 2027
City	:	CHICAGO
State	:	IL
Zip	:	60602-1708
Country	:	US
Telephone Number	:	312-920-9970
Fax Number	:	312-920-9971

Provider Business Practice Location Address
First Line	:	25 E WASHINGTON ST
Second Line	:	SUITE 2027
City	:	CHICAGO
State	:	IL
Zip	:	60602-1708
Country	:	US
Telephone Number	:	312-920-9970
Fax Number	:	312-920-9971

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

Provider Enumeration Date	:	03/21/2007
Last Update Date	:	07/08/2007

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