Kouimelis, Michael Demetrios

Kouimelis, Michael Demetrios is an individual health care provider with primary practice located at 9951 Rock Cut Xing , Loves Park IL 61111-1999. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Kouimelis, Michael Demetrios can be contacted via phone (815) 639-8500.

Contact Information

Primary practice address
9951 Rock Cut Xing Loves Park IL 61111-1999
Phone: (815) 639-8500
Fax: (815) 639-8501
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 036121741 Illinois

Profile Details

NPI number 1033373907
LBN Legal business name Kouimelis, Michael Demetrios
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 10th, 2008
Last updated Jan 28th, 2021 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1033373907 NPPES
Illinois MEDICAID 036121741
Illinois Other 553180
Illinois Other 834370

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