Provider Demographics
NPI:1568647675
Name:RENATA VARIAKOJIS MDSC
Entity Type:Organization
Organization Name:RENATA VARIAKOJIS MDSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:RENATA
Authorized Official - Middle Name:J
Authorized Official - Last Name:VARIAKOJIS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:708-361-5550
Mailing Address - Street 1:PO BOX 379
Mailing Address - Street 2:
Mailing Address - City:ORLAND PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60462-0379
Mailing Address - Country:US
Mailing Address - Phone:708-460-9836
Mailing Address - Fax:708-460-1117
Practice Address - Street 1:7600 W COLLEGE DR
Practice Address - Street 2:
Practice Address - City:PALOS HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60463-1001
Practice Address - Country:US
Practice Address - Phone:708-361-5550
Practice Address - Fax:708-361-5624
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-08
Last Update Date:2008-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
01637958OtherBLUE CROSS BLUE SHIELD GR
215886Medicare PIN