Peter S Alexopoulos

Primary specialty

DentistTaxonomy code 122300000X

License

19-A16194 Issued in IL

Practice address

5214 N Western Ave
Chicago, IL 60625-2589

Phone

(773) 271-3300

Fax

(773) 293-1500

NPI assigned

Apr 29, 2015

Sex

Male

Sole proprietor

Yes

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Apr 29, 2015.

{
    "created_epoch": "1430265600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1430265600000",
    "number": "1295112142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5214 N WESTERN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606252589",
            "telephone_number": "773-271-3300",
            "fax_number": "773-293-1500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5214 N WESTERN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606252589",
            "telephone_number": "773-271-3300",
            "fax_number": "773-293-1500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALEXOPOULOS",
        "first_name": "PETER",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-04-29",
        "last_updated": "2015-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "19-A16194",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Chicago, IL
• Dentist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.