Individual
DR. DANTE ANTHONY PIMENTEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
6032 S HALSTED ST, SUITE 102, CHICAGO, IL 60621-2112
(773) 651-9200
(773) 651-9203
Mailing address
326 W 64TH ST, CHICAGO, IL 60621-3114
(855) 276-5212
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
036111599
IL
208M00000X
Hospitalist Physician
036111599
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036111599
—
IL
01
—
1634551
BLUE CROSS BLUE SHIELD
IL
01
—
211054
MEDICARE GROUP
IL
01
—
P00340190
PALMETTO GBA-RAILROAD
IL
Enumeration date
10/07/2005
Last updated
07/22/2022
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