Provider Demographics
NPI:1114358892
Name:ARESTOPOULOS, NIKOLAS (LAC, DIPL OM)
Entity Type:Individual
Prefix:MR
First Name:NIKOLAS
Middle Name:
Last Name:ARESTOPOULOS
Suffix:
Gender:M
Credentials:LAC, DIPL OM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 N KINGSBURY ST
Mailing Address - Street 2:RIVERWALK 6-A
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60654-8114
Mailing Address - Country:US
Mailing Address - Phone:312-321-0004
Mailing Address - Fax:
Practice Address - Street 1:600 N KINGSBURY ST
Practice Address - Street 2:RIVERWALK 6-A
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60654-8114
Practice Address - Country:US
Practice Address - Phone:312-321-0004
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-12-06
Last Update Date:2013-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL198.001143171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist