Provider Demographics
NPI:1336137546
Name:KONTOS, GEORGE JOHN JR (MD)
Entity Type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:JOHN
Last Name:KONTOS
Suffix:JR
Gender:M
Credentials:MD
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Mailing Address - Street 1:855 ILLINI DR STE 304
Mailing Address - Street 2:
Mailing Address - City:SILVIS
Mailing Address - State:IL
Mailing Address - Zip Code:61282-2904
Mailing Address - Country:US
Mailing Address - Phone:309-281-2120
Mailing Address - Fax:309-281-2129
Practice Address - Street 1:855 ILLINI DR
Practice Address - Street 2:STE 304
Practice Address - City:SILVIS
Practice Address - State:IL
Practice Address - Zip Code:61282-2907
Practice Address - Country:US
Practice Address - Phone:309-281-2120
Practice Address - Fax:309-281-2129
Is Sole Proprietor?:No
Enumeration Date:2005-10-11
Last Update Date:2021-04-25
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IL036-117105208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILK35410Medicare PIN
E91811Medicare UPIN