Doctor Name: | DR. VASILIOS LITSAS |
NPI Number: | 1114958543 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | DPM |
License Number: | 016005036 |
Business Practice Address: | 4705 Willow Springs Rd S.e. Suite La Grange, IL - 605256145 |
Business Phone Number: | 7085880250 |
Business Fax Number: | 7085880256 |
Mailing Address: | 4705 Willow Springs Rd, S.e. Suite LA GRANGE |
State: | IL |
Postal Code: | 605256145 |
Phone Number: | 7085880250 |
Fax Number: | 7085880256 |
NPI Enumeration Date: | 07/05/2006 |
NPI Last Update Date: | 07/31/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 213ES0103X |
License Number: | 016005036 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
Taxonomy Classification: | Podiatrist |
Taxonomy Specialization: | Foot & Ankle Surgery |
Taxonomy Definition: |