Active NPI
Dimitrios George Tsakos, PHARM.D
- Pharmacist
- Lindenhurst, IL
National Provider Identifier
1225310568
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 051038387
- Practice address
- 399 South Route 45
Lindenhurst, IL 60046 - Phone
- (847) 356-2066
- Fax
- (847) 356-2194
- NPI assigned
- Sep 13, 2011
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 051038387 | IL | Primary |
Addresses
Primary practice location
399 South Route 45
Lindenhurst, IL 60046
Mailing address
490 Crystal PL
Gurnee, IL 60031-4076
Phone (847) 356-2066
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 051.038387 | Other | IL | STATE LISCENCE IL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 051038387 | IL | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Pharmacy
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- NPI 1629956545
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1315872000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1315872000000",
"number": "1225310568",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "490 CRYSTAL PL",
"city": "GURNEE",
"state": "IL",
"postal_code": "600314076",
"telephone_number": "847-356-2066",
"fax_number": "847-356-2194"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "399 SOUTH ROUTE 45",
"city": "LINDENHURST",
"state": "IL",
"postal_code": "60046",
"telephone_number": "847-356-2066",
"fax_number": "847-356-2194"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TSAKOS",
"first_name": "DIMITRIOS",
"middle_name": "GEORGE",
"name_prefix": "Dr.",
"credential": "PHARM.D",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-09-13",
"last_updated": "2011-09-13",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "IL",
"license": "051038387",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LISCENCE IL",
"identifier": "051.038387",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lindenhurst, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.