SOTERIOS G POLYCHRONOPOULOS (NPI# 1346232493) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1346232493 |
| Entity Type | Individual |
| Full Name | SOTERIOS G POLYCHRONOPOULOS |
| Credential | MD |
| Practice Address |
11638 S Western Ave Chicago IL 60643 |
| Practice Telephone | 7734452422 |
| Practice Fax Number | 7734455182 |
| Mailing Telephone | 7734452422 |
| Mailing Fax Number | 7734455182 |
| Enumeration Date | 2005-08-16 |
| Last Update Date | 2016-11-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RP1001X |
Internal Medicine Specialization: Pulmonary Disease |
036051757 | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | 036051757 | 05 | |
| IL | RR | 110019213 | 01 |
| IL | BC-BS | 31602250 | 01 |
| Street Address |
11638 S WESTERN AVE |
| City | CHICAGO |
| State | IL |
| Zip Code | 60643 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265823918 | Dialysis At Home | Clinic/Center | 11638 S Western Ave, Chicago, IL 60643-4730 | 2015-02-16 |
| 1790777837 | Asklepios Medical Group Ltd | Internal Medicine | 11638 S Western Ave, Chicago, IL 60643-4730 | 2005-08-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154941698 | Breann Hampton | Behavior Technician | 1214 W 115th St, Chicago, IL 60643 | 2020-04-24 |
| 1366075566 | Sanctuary Counseling, LLC | Home Health | 12247 S Racine Ave, Calumet Park, IL 60643 | 2020-02-16 |
| 1467082883 | Juliana Frances Cunningham | Developmental Therapist | 10037 S Bell, Chicago, IL 60643 | 2020-01-24 |
| 1013578624 | Sct Counseling | Counselor | 11948 S Western Ave, Chicago, IL 60643 | 2019-06-25 |
| 1073087474 | For Eyes Optical Company of Pa | Optometrist | 9900 S Ridgleland Ave, Chicago Ridge, IL 60643 | 2019-01-18 |
| 1073096426 | Derek Peake | Physical Therapist | 9465 S. Western Road, Chicago, IL 60643 | 2018-09-12 |
| 1508356072 | Halo Medical Professionals Sc. | Chiropractor | 10650 S Western Ave, Chicago, IL 60643 | 2018-05-10 |
| 1811405699 | Kara Eileen Noland | Developmental Therapist | 9327 S Hamilton Ave, Chicago, IL 60643 | 2018-01-16 |
| 1588173546 | Kiah Nicole Bouie | Behavioral Analyst | 1461 W 113th Pl, Chicago, IL 60643 | 2017-09-21 |
| 1174042766 | Travis Wade Robertson | Physical Therapist | 10909-11 S Western Ave, Beverly, IL 60643 | 2017-09-14 |
| Find all providers in zip 60643 | ||||
| Taxonomy Code | 207RP1001X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Pulmonary Disease |
| An internist who treats diseases of the lungs and airways. The pulmonologist diagnoses and treats cancer, pneumonia, pleurisy, asthma, occupational and environmental diseases, bronchitis, sleep disorders, emphysema and other complex disorders of the lungs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861835985 | Christie Ann Brillante | Internal Medicine | 1801 W. Taylor, Suite 3c, Chicago, IL 60612-4795 | 2013-04-08 |
| 1154564607 | Kevin Patrick Haas | Internal Medicine | 840 S Wood St # Mc719, Chicago, IL 60612-4325 | 2009-04-14 |
| 1427194638 | Diane Tate | Internal Medicine | 6547 N Avondale Ave, Suite 001, Chicago, IL 60631-1573 | 2007-01-29 |
| 1760534192 | Anita A Shah | Internal Medicine | 2800 N Sheridan Rd Ste 301, Chicago, IL 60657-6158 | 2007-01-17 |
| 1891853016 | Romeo Lee Uy | Internal Medicine | 5140 North California Ave, Suite 620, Chicago, IL 60625 | 2006-12-04 |
| 1861560724 | Alvin Jerry Schonfeld | Internal Medicine | 438 W Saint James Pl, Chicago, IL 60614-2750 | 2006-11-30 |
| 1154405801 | Nicholas Gross | Internal Medicine | 1414 N Wells St, Apt. 407, Chicago, IL 60610-1374 | 2006-10-25 |
| 1285724765 | Howard Arya Jaffe | Internal Medicine | 820 South Damen Street, Pccsm, Dept Med (111), Jesse Brown Va Medical Center, Chicago, IL 60612 | 2006-10-13 |
| 1346340650 | Ricky Johnson | Internal Medicine | 2011 E 75th St, Chicago, IL 60649-3607 | 2006-09-25 |
| 1215041462 | Patricia S Mikes Md Sc | Internal Medicine | 201 E Huron St Ste 11-245, Chicago, IL 60611-2867 | 2006-08-17 |
| Find all providers in CHICAGO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.