Poulos, Dorothea
Poulos, Dorothea is an sole proprietor health care provider with primary practice located at 87 N Airlite St Ste 130 , Elgin IL 60123-4991. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Poulos, Dorothea can be contacted via phone (847) 888-3661.Contact Information
Primary practice address
87 N Airlite St Ste 130
Elgin IL 60123-4991
Phone: (847) 888-3661
Fax: (847) 888-9964
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 036-066780 | Illinois |
Profile Details
| NPI number | 1003804519 |
|---|---|
| LBN Legal business name | Poulos, Dorothea |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Oct 10th, 2005 |
| Last updated | Dec 3rd, 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1003804519 | NPPES |
| Illinois | MEDICAID | 036066780 | |
| Illinois | Other | 110021524 |
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