Provider Demographics
NPI:1417122599
Name:DIMITROPOULOS, STAMATIS (MD)
Entity Type:Individual
Prefix:
First Name:STAMATIS
Middle Name:
Last Name:DIMITROPOULOS
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 1:8110 S CASS AVE
Mailing Address - Street 2:
Mailing Address - City:DARIEN
Mailing Address - State:IL
Mailing Address - Zip Code:60561-5013
Mailing Address - Country:US
Mailing Address - Phone:630-963-4000
Mailing Address - Fax:630-920-1901
Practice Address - Street 1:8110 S CASS AVE
Practice Address - Street 2:
Practice Address - City:DARIEN
Practice Address - State:IL
Practice Address - Zip Code:60561-5013
Practice Address - Country:US
Practice Address - Phone:630-963-4000
Practice Address - Fax:630-920-1901
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-29
Last Update Date:2021-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036114665207RC0000X, 207RI0011X
IL036-114665207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology