Provider Demographics
NPI:1144471772
Name:SPYRO D. ANALYTIS, MDPC
Entity type:Organization
Organization Name:SPYRO D. ANALYTIS, MDPC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MDPC
Authorized Official - Prefix:DR
Authorized Official - First Name:SPYRO
Authorized Official - Middle Name:D
Authorized Official - Last Name:ANALYTIS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:815-634-8030
Mailing Address - Street 1:114 W WAVERLY ST
Mailing Address - Street 2:
Mailing Address - City:MORRIS
Mailing Address - State:IL
Mailing Address - Zip Code:60450-1422
Mailing Address - Country:US
Mailing Address - Phone:815-634-8030
Mailing Address - Fax:815-634-4052
Practice Address - Street 1:460 N BROADWAY ST
Practice Address - Street 2:
Practice Address - City:COAL CITY
Practice Address - State:IL
Practice Address - Zip Code:60416-1045
Practice Address - Country:US
Practice Address - Phone:815-634-8030
Practice Address - Fax:815-634-4052
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-01
Last Update Date:2008-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036078824207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty