Active NPI
Elliot A Petropoulos, MD
- Internal Medicine Physician
- Chicago, IL
National Provider Identifier
1225655665
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 125.07720
- Practice address
- 2525 S Michigan Ave
Chicago, IL 60616-2315 - Phone
- (312) 567-2000
- NPI assigned
- Jul 1, 2020
- 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 |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 125.07720 | IL | Primary |
Addresses
Primary practice location
2525 S Michigan Ave
Chicago, IL 60616-2315
Mailing address
2525 S Michigan Ave
Chicago, IL 60616-2315
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 Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 125.07720 | IL | MD | Internal Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1593561600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1594252800000",
"number": "1225655665",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2525 S MICHIGAN AVE",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606162315"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2525 S MICHIGAN AVE",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606162315",
"telephone_number": "312-567-2000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETROPOULOS",
"first_name": "ELLIOT",
"middle_name": "A",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-07-01",
"last_updated": "2020-07-09",
"certification_date": "2020-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "IL",
"license": "125.07720",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.