Provider Demographics
NPI:1932396488
Name:GEORGE TSATSOS
Entity Type:Organization
Organization Name:GEORGE TSATSOS
Other - Org Name:ANKLE N FOOT CENTER.COM
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:
Authorized Official - Last Name:TSATSOS
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:630-530-5757
Mailing Address - Street 1:2220 W BELMONT AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60618-6421
Mailing Address - Country:US
Mailing Address - Phone:773-348-7500
Mailing Address - Fax:630-203-1640
Practice Address - Street 1:401 N YORK RD
Practice Address - Street 2:
Practice Address - City:ELMHURST
Practice Address - State:IL
Practice Address - Zip Code:60126-5510
Practice Address - Country:US
Practice Address - Phone:630-530-5757
Practice Address - Fax:630-203-1640
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-28
Last Update Date:2007-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL16003058213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL16003058Medicaid
IL0472140001Medicare NSC
IL618912Medicare PIN
IL16003058Medicaid