Individual
PETER PANTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
7740 W NORTH AVE, ELMWOOD PARK, IL 60707-4124
(708) 452-7200
Mailing address
7740 W NORTH AVE, ELMWOOD PARK, IL 60707-4124
(708) 452-7200
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
036067167
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036-067167
—
IL
01
—
1609903
BLUE CROSS/BLUESHIELD IL
IL
Enumeration date
10/15/2005
Last updated
03/06/2017
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