Provider Demographics
NPI:1043484561
Name:PAPAGIANNIS, IOANNIS (MD)
Entity Type:Individual
Prefix:DR
First Name:IOANNIS
Middle Name:
Last Name:PAPAGIANNIS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:675 N SAINT CLAIR ST STE 14-100
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-5966
Mailing Address - Country:US
Mailing Address - Phone:312-695-7970
Mailing Address - Fax:312-695-4433
Practice Address - Street 1:675 N SAINT CLAIR ST STE 14-100
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-5966
Practice Address - Country:US
Practice Address - Phone:312-695-7970
Practice Address - Fax:312-695-4433
Is Sole Proprietor?:No
Enumeration Date:2008-04-15
Last Update Date:2020-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN47122207R00000X, 207RE0101X
KS0437429207RE0101X
IL036150945207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036150945OtherSTATE MEDICAL LICENSE