Provider Demographics
NPI:1295712545
Name:KOMPOLITI, AIKATERINI (MD)
Entity type:Individual
Prefix:DR
First Name:AIKATERINI
Middle Name:
Last Name:KOMPOLITI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1725 W HARRISON
Mailing Address - Street 2:#755
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60612-3824
Mailing Address - Country:US
Mailing Address - Phone:312-563-2900
Mailing Address - Fax:312-563-2024
Practice Address - Street 1:1725 W HARRISON
Practice Address - Street 2:#755
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60612-3824
Practice Address - Country:US
Practice Address - Phone:312-563-2030
Practice Address - Fax:312-563-2684
Is Sole Proprietor?:No
Enumeration Date:2005-12-28
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0360878602084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL336049765OtherIL DEPT OF PROF REG
IL036087860Medicaid
IL036087860Medicaid
G34093Medicare UPIN
ILL60629Medicare ID - Type Unspecified