Provider Demographics
NPI:1467436808
Name:TSATSOS, GEORGE (DPM)
Entity Type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:
Last Name:TSATSOS
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2220 W. BELMONT
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60618
Mailing Address - Country:US
Mailing Address - Phone:773-348-7500
Mailing Address - Fax:630-203-1640
Practice Address - Street 1:2220 W. BELMONT
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60618
Practice Address - Country:US
Practice Address - Phone:773-348-7500
Practice Address - Fax:630-203-1640
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-30
Last Update Date:2021-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL016003058213ES0000X, 213ES0103X, 213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
No213ES0000XPodiatric Medicine & Surgery Service ProvidersPodiatristSports Medicine
No213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL016003058Medicaid
ILT37305Medicare UPIN
ILL11982Medicare ID - Type UnspecifiedCHICAGO OFFICE
IL016003058Medicaid