Provider Demographics
NPI:1841583952
Name:C DEAN KATSAMAKIS DO FACC SC
Entity type:Organization
Organization Name:C DEAN KATSAMAKIS DO FACC SC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CONSTANTINE
Authorized Official - Middle Name:DEAN
Authorized Official - Last Name:KATSAMAKIS
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:847-904-7400
Mailing Address - Street 1:2720 DUNDEE RD
Mailing Address - Street 2:# 290
Mailing Address - City:NORTHBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60062-2609
Mailing Address - Country:US
Mailing Address - Phone:847-904-7400
Mailing Address - Fax:847-904-7401
Practice Address - Street 1:240 WAUKEGAN RD
Practice Address - Street 2:
Practice Address - City:GLENVIEW
Practice Address - State:IL
Practice Address - Zip Code:60025-5159
Practice Address - Country:US
Practice Address - Phone:847-904-7400
Practice Address - Fax:847-904-7401
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-23
Last Update Date:2018-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty
No207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional CardiologyGroup - Multi-Specialty