Provider Demographics
NPI:1568637866
Name:BOTROS, SAMUEL F (MD)
Entity Type:Individual
Prefix:DR
First Name:SAMUEL
Middle Name:F
Last Name:BOTROS
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 1:700 CUMBERLAND ST
Mailing Address - Street 2:
Mailing Address - City:HOFFMAN ESTATES
Mailing Address - State:IL
Mailing Address - Zip Code:60169-1835
Mailing Address - Country:US
Mailing Address - Phone:847-224-7845
Mailing Address - Fax:847-882-0844
Practice Address - Street 1:1 TIFFANY PT
Practice Address - Street 2:SUTIE G1
Practice Address - City:BLOOMINGDALE
Practice Address - State:IL
Practice Address - Zip Code:60108-2936
Practice Address - Country:US
Practice Address - Phone:847-466-5905
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-28
Last Update Date:2014-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036.118893207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology