Latall, John G

Latall, John G is an sole proprietor health care provider with primary practice located at 2073 N Clybourn Ave , Chicago IL 60614-4003. He recently has only one registered license in Allopathic & Osteopathic Physicians / Allergy & Immunology, which is considered as his primary health care specialty. Latall, John G can be contacted via phone (773) 665-4016.

Contact Information

Primary practice address
2073 N Clybourn Ave Chicago IL 60614-4003
Phone: (773) 665-4016
Fax: (773) 360-6200
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Allergy & Immunology 207K00000X 036084430 Illinois
Allopathic & Osteopathic Physicians / Allergy & Immunology 207K00000X 036-084430 Illinois

Profile Details

NPI number 1487630364
LBN Legal business name Latall, John G
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Dec 21st, 2005
Last updated Dec 14th, 2021 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1487630364 NPPES
Illinois MEDICAID 036084430 / 02
Illinois Other 01621679

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