Provider Demographics
NPI:1508922402
Name:FOTI CHRONOPOULOS MD SC
Entity Type:Organization
Organization Name:FOTI CHRONOPOULOS MD SC
Other - Org Name:WOMEN'S CARE GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:FOTI
Authorized Official - Middle Name:T
Authorized Official - Last Name:CHRONOPOULOS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:708-857-7230
Mailing Address - Street 1:5851 W 95TH ST
Mailing Address - Street 2:SUITE 400
Mailing Address - City:OAK LAWN
Mailing Address - State:IL
Mailing Address - Zip Code:60453-2394
Mailing Address - Country:US
Mailing Address - Phone:708-857-7230
Mailing Address - Fax:708-425-5779
Practice Address - Street 1:5851 W 95TH ST
Practice Address - Street 2:SUITE 400
Practice Address - City:OAK LAWN
Practice Address - State:IL
Practice Address - Zip Code:60453-2394
Practice Address - Country:US
Practice Address - Phone:708-857-7230
Practice Address - Fax:708-425-5779
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-28
Last Update Date:2016-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036093775207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036093775Medicaid
IL21622881OtherBCBS
IL21622881OtherBCBS
IL211143Medicare PIN