Tzanetakos, Nicholas George
Tzanetakos, Nicholas George is an individual health care provider with primary practice located at 99 Boulder Hill Pass , Montgomery IL 60538. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Tzanetakos, Nicholas George can be contacted via phone (630) 897-2848.Contact Information
Primary practice address
99 Boulder Hill Pass
Montgomery IL 60538
Phone: (630) 897-2848
Fax: (630) 897-4498
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 036066510 | Illinois |
Profile Details
| NPI number | 1720126535 |
|---|---|
| LBN Legal business name | Tzanetakos, Nicholas George |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 2nd, 2007 |
| Last updated | Jul 7th, 2017 - about 7 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 | 1720126535 | NPPES |
| Illinois | MEDICAID | 036066510 |
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