Provider Demographics
NPI:1952692717
Name:KOKOSIS, GEORGIOS (MD)
Entity Type:Individual
Prefix:
First Name:GEORGIOS
Middle Name:
Last Name:KOKOSIS
Suffix:
Gender:M
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 ST STE 425
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60612-3893
Mailing Address - Country:US
Mailing Address - Phone:312-563-3000
Mailing Address - Fax:
Practice Address - Street 1:1725 W HARRISON ST STE 425
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60612-3893
Practice Address - Country:US
Practice Address - Phone:312-563-3000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-04-28
Last Update Date:2020-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036.1523172086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery