Individual provider Active NPI

Stavros Orestis Alexopoulos, D.P.M.

  • Podiatrist
  • Chicago, IL
National Provider Identifier
1710102017
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
016004298 Issued in IL
Practice address
2740 W Foster Ave Ste 107
Chicago, IL 60625-3543
Phone
(773) 561-8100
NPI assigned
Apr 13, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 016004298 IL Primary

Addresses

Primary practice location

2740 W Foster Ave Ste 107
Chicago, IL 60625-3543

Mailing address

2740 W Foster Ave Ste 107
Chicago, IL 60625-3543
Phone (773) 561-8100

Other identifiers 1

IdentifierTypeStateIssuer
60010812OtherILBLUE SHIELD OF ILLINOIS

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110405000929 IL Practitioner - Podiatry 8527242197 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
016004298ILMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Stavros O Alexopoulos SC Podiatrist CurrentSince Jun 1, 2011 Accepting new patients
Diversey Medical Center SC Podiatrist PastSince Aug 11, 2010 Accepting new patients

Locations

2740 W Foster Ave
Ste 107
Chicago, IL 60625
Phone (773) 561-8100

Organizations & group practices 2

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.

Hospital & facility affiliations 2

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

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2740 W Foster Ave
Suite 107
Chicago, IL 60625-3532
Phone (773) 561-8100

Hospital & facility affiliations

  • Swedish Hospital Hospital, Chicago, IL, CCN 140114
  • Northshore University Healthsystem - Evanston Hospital Hospital, Evanston, IL, CCN 140010

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of nail tissue1-10
Removal or shaving of skin growth1-10
Skin biopsy1-10

NPI Registry JSON

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

{
    "created_epoch": "1176422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1710102017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2740 W FOSTER AVE STE 107",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606253543",
            "telephone_number": "773-561-8100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2740 W FOSTER AVE STE 107",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606253543",
            "telephone_number": "773-561-8100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALEXOPOULOS",
        "first_name": "STAVROS",
        "middle_name": "ORESTIS",
        "credential": "D.P.M.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "IL",
            "license": "016004298",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD OF ILLINOIS",
            "identifier": "60010812",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.