Provider Demographics
NPI:1871501825
Name:GIOKARIS, DEMETRIOS J (MD)
Entity Type:Individual
Prefix:MR
First Name:DEMETRIOS
Middle Name:J
Last Name:GIOKARIS
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 1:4921 N WESTERN AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60625-1921
Mailing Address - Country:US
Mailing Address - Phone:773-784-9669
Mailing Address - Fax:773-989-6442
Practice Address - Street 1:4921 N WESTERN AVENUE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60625
Practice Address - Country:US
Practice Address - Phone:773-784-9669
Practice Address - Fax:773-989-6442
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-04
Last Update Date:2015-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036066354207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL36066354Medicaid
732030Medicare ID - Type Unspecified
C46143Medicare UPIN