Organization
JOHN G LATALL MD SC
Active
Other names
Premier Allergy, Asthma and Sinus SC
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN G LATALL M.D. (PRESIDENT)
(773) 665-4016
Entity
Organization
Contact information
Practice address
2073 N CLYBOURN AVE, CHICAGO, IL 60614-4003
(773) 665-4016
(773) 360-6200
Mailing address
2073 N CLYBOURN AVE, CHICAGO, IL 60614-4003
(773) 665-4016
(773) 665-0403
Taxonomy
Speciality
Code
Description
License number
State
207KA0200X
Allergy Physician
Primary
—
—
261QM2500X
Medical Specialty Clinic/Center
036-084430
IL
Other
Enumeration date
04/04/2012
Last updated
10/05/2022
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