# ENDOCRINE DIABETES CLINIC LTD

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1598006546
- **Authorized official:** DR. ABDALLAH ALTARSHAN MD (PRESIDENT)
- **Authorized official phone:** (708) 479-6522

## Contact information

- **Practice address:** 3830 W 95TH ST, EVERGREEN PARK, IL 60805-2004
- **Practice address phone:** (708) 479-6522
- **Mailing address:** 3830 W 95TH ST, EVERGREEN PARK, IL 60805-2004
- **Mailing address phone:** (708) 479-6522

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RE0101X | Endocrinology, Diabetes & Metabolism Physician | 036093254 | IL | Yes |

## Other

- **Enumeration date:** 03/14/2013
- **Last updated:** 03/14/2013