Provider Demographics
NPI:1609036029
Name:CHRISTOPOULOS, NIKI A (MD)
Entity type:Individual
Prefix:
First Name:NIKI
Middle Name:A
Last Name:CHRISTOPOULOS
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1017 W WASHINGTON BLVD UNIT 2K
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60607-2106
Mailing Address - Country:US
Mailing Address - Phone:773-459-6815
Mailing Address - Fax:
Practice Address - Street 1:215 N PEORIA ST FL 1
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60607-1754
Practice Address - Country:US
Practice Address - Phone:312-445-9827
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-10
Last Update Date:2025-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036114589208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery