Provider Demographics
NPI:1477726396
Name:SPIROS K. ANALITIS, M.D.,P.C.
Entity Type:Organization
Organization Name:SPIROS K. ANALITIS, M.D.,P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SPIROS
Authorized Official - Middle Name:K
Authorized Official - Last Name:ANALITIS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:847-382-6042
Mailing Address - Street 1:1885 N BRAYMORE DR
Mailing Address - Street 2:
Mailing Address - City:INVERNESS
Mailing Address - State:IL
Mailing Address - Zip Code:60010-6406
Mailing Address - Country:US
Mailing Address - Phone:847-382-6042
Mailing Address - Fax:
Practice Address - Street 1:2350 N ROCKTON AVE
Practice Address - Street 2:
Practice Address - City:ROCKFORD
Practice Address - State:IL
Practice Address - Zip Code:61103-3600
Practice Address - Country:US
Practice Address - Phone:815-971-5550
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-11
Last Update Date:2008-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036069744282NC0060X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC0060XHospitalsGeneral Acute Care HospitalCritical Access
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL31602518OtherBLUE SHIELD OF ILLINOIS
IL31602518OtherBLUE SHIELD OF ILLINOIS
IL212379Medicare PIN