Provider Demographics
NPI:1245205210
Name:KARAHALIOS, DEAN G (MD)
Entity Type:Individual
Prefix:
First Name:DEAN
Middle Name:G
Last Name:KARAHALIOS
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 1:3825 HIGHLAND AVE STE 306
Mailing Address - Street 2:
Mailing Address - City:DOWNERS GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60515-1562
Mailing Address - Country:US
Mailing Address - Phone:630-929-0633
Mailing Address - Fax:
Practice Address - Street 1:1700 LUTHER LN STE 1170
Practice Address - Street 2:
Practice Address - City:PARK RIDGE
Practice Address - State:IL
Practice Address - Zip Code:60068-1270
Practice Address - Country:US
Practice Address - Phone:844-376-3876
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-22
Last Update Date:2024-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01056796A207T00000X
WI74114-20207T00000X
IL036097583207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036097583Medicaid
WI100148842Medicaid
ILK27178Medicare PIN
F95560Medicare UPIN