Individual provider Active NPI

George G. Theotikos, D.O.

  • Anesthesiology Physician
  • Oak Park, IL
National Provider Identifier
1245282219
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
036090978 Issued in IL
Practice address
3 Erie CT
Oak Park, IL 60302-2519
Phone
(708) 383-6200
NPI assigned
May 17, 2006
Last updated
Mar 7, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 036090978 IL Primary
Interventional Pain Medicine Physician 208VP0014X 036090978 IL

Addresses

Primary practice location

3 Erie CT
Oak Park, IL 60302-2519

Mailing address

424 N County Line Rd
Hinsdale, IL 60521-3804
Phone (630) 654-8623

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040313000163 IL Practitioner - Anesthesiology 5799674115 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Midwestern University, Chicago College of Osteopathic Med, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Anesthesia Associates, LTDGroup PAC ID 2961303425, 34 clinicians

Practice addresses (Care Compare)

1 Kish Hospital Dr
Dekalb, IL 60115-9602

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy, Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036090978ILMDInterventional Pain Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Central Dupage Physician Group CurrentSince Mar 1, 2020 Accepting new patients
North American Partners in Anesthesia (Illinois), LLC Anesthesiology CurrentSince Jul 1, 2012 Accepting new patients
Central Dupage Physician Group CurrentSince Mar 1, 2020 Accepting new patients
Anesthesia Associates, LTD CurrentSince May 20, 2020 Accepting new patients

Locations

3249 Oak Park Ave
Berwyn, IL 60402
Phone (708) 783-2696

Dept 5777
Carol Stream, IL 60122

1 Kish Hospital Dr
DeKalb, IL 60115
Phone (815) 754-1521

3 Erie Ct
Oak Park, IL 60302
Phone (708) 763-6200

3 Erie Ct
Ste 220
Oak Park, IL 60302

100 5th St
Oswego, IL 60543
Phone (630) 449-0085

1800 N Main St
Wheaton, IL 60187
Phone (630) 469-0045

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1147824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1245282219",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "424 N COUNTY LINE RD",
            "city": "HINSDALE",
            "state": "IL",
            "postal_code": "605213804",
            "telephone_number": "630-654-8623"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 ERIE CT",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "603022519",
            "telephone_number": "708-383-6200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THEOTIKOS",
        "first_name": "GEORGE",
        "middle_name": "G.",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-17",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "IL",
            "license": "036090978",
            "primary": true
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "IL",
            "license": "036090978",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oak Park, IL

Sources for this page

Verify at the official NPI Registry.