Provider Demographics
NPI:1679922447
Name:TRAKAS, DEMETRIUS (MD)
Entity type:Individual
Prefix:DR
First Name:DEMETRIUS
Middle Name:
Last Name:TRAKAS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1616 SHERIDAN RD
Mailing Address - Street 2:10 G
Mailing Address - City:WILMETTE
Mailing Address - State:IL
Mailing Address - Zip Code:60091-1875
Mailing Address - Country:US
Mailing Address - Phone:773-547-0006
Mailing Address - Fax:
Practice Address - Street 1:1616 SHERIDAN RD
Practice Address - Street 2:10 G
Practice Address - City:WILMETTE
Practice Address - State:IL
Practice Address - Zip Code:60091-1875
Practice Address - Country:US
Practice Address - Phone:773-547-0006
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-12
Last Update Date:2016-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036.0423242084P0800X, 2084P0805X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0805XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyGeriatric Psychiatry
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry