NPI: 1134485055
Provider Name: JOHN G LATALL MD SC
Doing Business As: PREMIER ALLERGY, ASTHMA AND SINUS SC
Classification: Clinic/Center - 261QM2500X
Entity Type: Organization
Specialization: Medical Specialty
Address:
1317 W DIVERSEY PKWY
CHICAGO, IL
ZIP 60614
Phone: (773) 665-4016
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JOHN G LATALL MD SC is a medical specialty clinic center in Chicago, IL. The provider is an entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer). JOHN G LATALL MD SC NPI is 1134485055. The provider is registered as an organization entity type.
The provider Is Doing Business As Premier Allergy, Asthma And Sinus Sc.
The provider's business location address is:
1317 W DIVERSEY PKWY
CHICAGO, IL
ZIP 60614-207
Phone: (773) 665-4016
Fax: (773) 665-0403
The provider's authorized official is John G Latall .
The authorized official title is President and has the following contact phone number (773) 665-4016.
The enumeration date for this NPI number is 4/4/2012 and was last updated on 4/4/2012.