Angelo Tsakopoulos MD SC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

036111440 Issued in IL

Legal business name

ANGELO TSAKOPOULOS MD SC

Practice address

19550 Governors Hwy
Suite 2700
Flossmoor, IL 60422-2125

Phone

(708) 798-9170

Fax

(708) 798-9173

NPI assigned

Dec 17, 2007

Last updated

Nov 25, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Angelo G Tsakopoulos, MD

Title

MD

Phone

(708) 798-9170

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1197849600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1259107200000",
    "number": "1881877520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1149",
            "city": "MATTESON",
            "state": "IL",
            "postal_code": "604434149",
            "telephone_number": "708-747-5850",
            "fax_number": "708-747-9991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19550 GOVERNORS HWY",
            "address_2": "SUITE 2700",
            "city": "FLOSSMOOR",
            "state": "IL",
            "postal_code": "604222125",
            "telephone_number": "708-798-9170",
            "fax_number": "708-798-9173"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANGELO TSAKOPOULOS MD SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-17",
        "last_updated": "2009-11-25",
        "status": "A",
        "authorized_official_last_name": "TSAKOPOULOS",
        "authorized_official_first_name": "ANGELO",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "708-798-9170",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036111440",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSIL GROUP #",
            "identifier": "1639013",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Flossmoor, IL
• Providers in Flossmoor, IL by specialty
• Family Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2009; 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.