Provider Demographics
NPI:1205005691
Name:HYGEIA MEDICAL GROUP SC
Entity Type:Organization
Organization Name:HYGEIA MEDICAL GROUP SC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:BASIL
Authorized Official - Last Name:CHRONIS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:708-361-4211
Mailing Address - Street 1:10660 W 143RD ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:ORLAND PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60462-1982
Mailing Address - Country:US
Mailing Address - Phone:708-460-4499
Mailing Address - Fax:708-460-8031
Practice Address - Street 1:12211 S HARLEM AVE
Practice Address - Street 2:
Practice Address - City:PALOS HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60463-1471
Practice Address - Country:US
Practice Address - Phone:708-361-4211
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-29
Last Update Date:2008-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILCF1204OtherPALMETTO RR MEDICARE