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Contact Information

TALIA MAVROGIANNIS
2160 S 1ST AVE
MAYWOOD, IL60153-3328
 Phone: 708-216-9122
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Physician Assistant

363A00000X 97 Physician Assistant
 

Foot and Ankle Surgery

207XX0004X 02 Physician/General Surgery
Indicates primary specialty

NPI Profile & details for TALIA MAVROGIANNIS · (Female)

NPI # 1750030441
Status Active
Credentials
Entity Individual
Enumeration date 03/21/2022
Last updated 01/29/2025 - More than a year ago
Sole proprietor 1 No
Identifiers
  • IL License # 085.008933
  • IL License # 085008933
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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