Provider Demographics
NPI:1437222569
Name:STAMELOS BROS LTD
Entity type:Organization
Organization Name:STAMELOS BROS LTD
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SPIROS
Authorized Official - Middle Name:G
Authorized Official - Last Name:STAMELOS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:847-632-1300
Mailing Address - Street 1:1734 W ALGONQUIN RD
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60005-3405
Mailing Address - Country:US
Mailing Address - Phone:847-632-1300
Mailing Address - Fax:847-632-1530
Practice Address - Street 1:1734 W ALGONQUIN RD
Practice Address - Street 2:
Practice Address - City:ARLINGTON HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60005-3405
Practice Address - Country:US
Practice Address - Phone:847-632-1300
Practice Address - Fax:847-632-1530
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-16
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL131114300OtherDEPT OF LABOR
IL21607018OtherBLUE CROSS BLUE SHIELD
IL036049690Medicaid
IL036049690Medicaid
ILC51410Medicare UPIN
IL21607018OtherBLUE CROSS BLUE SHIELD
IL0755410001Medicare NSC