Provider Demographics
NPI:1649386889
Name:GALANOPOULOS, ALISON CAROLE (MD)
Entity Type:Individual
Prefix:DR
First Name:ALISON
Middle Name:CAROLE
Last Name:GALANOPOULOS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:ALISON
Other - Middle Name:CAROLE
Other - Last Name:WEIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:9669 KENTON AVE
Mailing Address - Street 2:SUITE 403
Mailing Address - City:SKOKIE
Mailing Address - State:IL
Mailing Address - Zip Code:60076-1266
Mailing Address - Country:US
Mailing Address - Phone:847-674-4730
Mailing Address - Fax:847-674-4732
Practice Address - Street 1:9669 KENTON AVE
Practice Address - Street 2:SUITE 403
Practice Address - City:SKOKIE
Practice Address - State:IL
Practice Address - Zip Code:60076-1266
Practice Address - Country:US
Practice Address - Phone:847-674-4730
Practice Address - Fax:847-674-4732
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-21
Last Update Date:2021-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036109959174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL0081647049Medicare ID - Type UnspecifiedEXISTING BCBS PROVIDER #