Provider Demographics
NPI:1205910130
Name:MICHAEL J KARASIS M.D. S.C.
Entity type:Organization
Organization Name:MICHAEL J KARASIS M.D. S.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:J
Authorized Official - Last Name:KARASIS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:847-429-0571
Mailing Address - Street 1:526 W SOUTH ST
Mailing Address - Street 2:
Mailing Address - City:WOODSTOCK
Mailing Address - State:IL
Mailing Address - Zip Code:60098-3749
Mailing Address - Country:US
Mailing Address - Phone:815-338-3200
Mailing Address - Fax:
Practice Address - Street 1:526 W SOUTH ST
Practice Address - Street 2:
Practice Address - City:WOODSTOCK
Practice Address - State:IL
Practice Address - Zip Code:60098-3749
Practice Address - Country:US
Practice Address - Phone:815-338-3200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-25
Last Update Date:2009-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL36051379208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILD93804Medicare UPIN
IL641660Medicare ID - Type Unspecified