Individual
PAUL BALTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
855 MADISON ST, OAK PARK, IL 60302-4420
(708) 386-1000
(708) 386-2394
Mailing address
855 MADISON ST, OAK PARK, IL 60302-4420
(708) 386-1000
(708) 386-2394
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
036040403
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036040403
—
IL
Enumeration date
08/10/2005
Last updated
11/10/2020
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