Provider Demographics
NPI:1972657666
Name:GEORGE SKARPATHIOTIS, M.D., S.C.
Entity Type:Organization
Organization Name:GEORGE SKARPATHIOTIS, M.D., S.C.
Other - Org Name:PALOS PEDIATRICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:I
Authorized Official - Last Name:SKARPATHIOTIS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:708-923-6300
Mailing Address - Street 1:7110 W 127TH ST
Mailing Address - Street 2:
Mailing Address - City:PALOS HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60463-1571
Mailing Address - Country:US
Mailing Address - Phone:708-923-6300
Mailing Address - Fax:708-923-6303
Practice Address - Street 1:7110 W 127TH ST
Practice Address - Street 2:
Practice Address - City:PALOS HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60463-1571
Practice Address - Country:US
Practice Address - Phone:708-923-6300
Practice Address - Fax:708-923-6303
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-22
Last Update Date:2015-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-070269208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1932212677OtherNPI
IL1073563243OtherNPI
IL1447201132OtherNPI
IL1477566776OtherNPI