Provider Demographics
NPI:1821025289
Name:G & T ORTHOPAEDICS AND SPORTS MEDICINE
Entity type:Organization
Organization Name:G & T ORTHOPAEDICS AND SPORTS MEDICINE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOS
Authorized Official - Middle Name:
Authorized Official - Last Name:GIANNOULIAS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:630-782-1174
Mailing Address - Street 1:1200 S YORK RD
Mailing Address - Street 2:SUITE 4190
Mailing Address - City:ELMHURST
Mailing Address - State:IL
Mailing Address - Zip Code:60126-5626
Mailing Address - Country:US
Mailing Address - Phone:630-782-1174
Mailing Address - Fax:773-275-2443
Practice Address - Street 1:1200 S YORK RD
Practice Address - Street 2:SUITE 4190
Practice Address - City:ELMHURST
Practice Address - State:IL
Practice Address - Zip Code:60126-5626
Practice Address - Country:US
Practice Address - Phone:630-782-1174
Practice Address - Fax:773-275-2443
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-28
Last Update Date:2015-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL02232584OtherBCBS GROUP
IL610189700OtherDEPT OF LABOR
ILDC2601OtherRAILROAD MEDICARE GROUP
IL210414Medicare PIN