Provider Demographics
NPI:1194791871
Name:HATSERAS, ARGYRO SYLVIA (MD)
Entity type:Individual
Prefix:DR
First Name:ARGYRO
Middle Name:SYLVIA
Last Name:HATSERAS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 735044
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60673-5044
Mailing Address - Country:US
Mailing Address - Phone:800-326-2250
Mailing Address - Fax:
Practice Address - Street 1:945 N 12TH ST
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53233-1305
Practice Address - Country:US
Practice Address - Phone:414-219-2000
Practice Address - Fax:414-219-6161
Is Sole Proprietor?:No
Enumeration Date:2006-02-23
Last Update Date:2024-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036104244207R00000X, 207RC0200X, 207RP1001X
WI56385207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036104244Medicaid
ILP00446529OtherRR INDIVIDUAL
WI100017810Medicaid
IL833120OtherMEDICARE GROUP #
ILCA2264OtherRR GROUP
IL2613OtherGROUP #
ILF25991Medicare UPIN
ILP00446529OtherRR INDIVIDUAL
ILCA2264OtherRR GROUP