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JOHN G LATALL MD

Allergy and Immunology

Chicago, Illinois

Provider NPI: 1487630364

Provider Information:
 JOHN G LATALL MD


Practice Location:
2073 N CLYBOURN AVE  CHICAGO, IL 60614 US
Tel: 773-665-4016  Fax: --

Business Mailing Address:
  ,   
Tel: --  Fax: --


Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
N207K00000XPhysicians
Allergy & Immunology
IL036084430
Y207K00000XPhysicians
Allergy & Immunology
IL036-084430

Other Provider Identifiers:

IssuerNumberStateType
036084430 / 02IL05
BCBS OF IL01621679IL01
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin




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