Provider Demographics
NPI:1508998170
Name:BAKIS, SPYROS (DC, CCSP)
Entity Type:Individual
Prefix:DR
First Name:SPYROS
Middle Name:
Last Name:BAKIS
Suffix:
Gender:M
Credentials:DC, CCSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8424 SKOKIE BLVD STE 207
Mailing Address - Street 2:
Mailing Address - City:SKOKIE
Mailing Address - State:IL
Mailing Address - Zip Code:60077-2568
Mailing Address - Country:US
Mailing Address - Phone:847-470-1177
Mailing Address - Fax:847-470-0368
Practice Address - Street 1:16 N PEORIA ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60607-2609
Practice Address - Country:US
Practice Address - Phone:312-346-9355
Practice Address - Fax:847-470-0368
Is Sole Proprietor?:No
Enumeration Date:2007-03-09
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038-006760111NS0005X, 111NN0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN0400XChiropractic ProvidersChiropractorNeurology
No111NS0005XChiropractic ProvidersChiropractorSports Physician
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILL76236Medicare UPIN
IL572220Medicare ID - Type Unspecified