Provider Demographics
NPI:1710980339
Name:HIOTIS, LOUIS (MD)
Entity Type:Individual
Prefix:MR
First Name:LOUIS
Middle Name:
Last Name:HIOTIS
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 1:200 S MICHIGAN AVENUE
Mailing Address - Street 2:#805
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60604
Mailing Address - Country:US
Mailing Address - Phone:312-922-3815
Mailing Address - Fax:312-922-7449
Practice Address - Street 1:200 S. MICHIGAN AVENUE
Practice Address - Street 2:#805
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60604
Practice Address - Country:US
Practice Address - Phone:312-922-3815
Practice Address - Fax:312-922-7449
Is Sole Proprietor?:No
Enumeration Date:2005-05-27
Last Update Date:2011-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-108161207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036108161Medicaid
IL036108161Medicaid
ILI18126Medicare UPIN
IL427330Medicare ID - Type UnspecifiedMEDICARE GROUP