Provider Demographics
NPI:1285894550
Name:ANDRIANOPOULOS, EFI (DDS)
Entity type:Individual
Prefix:DR
First Name:EFI
Middle Name:
Last Name:ANDRIANOPOULOS
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5811 N LINCOLN AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60659-4601
Mailing Address - Country:US
Mailing Address - Phone:773-275-4707
Mailing Address - Fax:773-275-8070
Practice Address - Street 1:5811 N LINCOLN AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60659-4601
Practice Address - Country:US
Practice Address - Phone:773-275-4707
Practice Address - Fax:773-275-8070
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-11
Last Update Date:2008-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL19A15855122300000X
IL0210011051223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics
No122300000XDental ProvidersDentist