MEDICARE: EMMA D LANTOS MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207VC0300X	Complex Family Planning Physician	A176641	CA
2	390200000X	Student in an Organized Health Care Education/Training Program
3	207V00000X	Obstetrics & Gynecology Physician	A176641	CA

General Provider Information

NPI Number	:	1265937742
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EMMA D LANTOS MD

Provider Business Mailing Address
First Line	:	251 E HURON ST
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60611-3055
Country	:	US
Telephone Number	:	312-926-2000
Fax Number	:

Provider Business Practice Location Address
First Line	:	251 E HURON ST
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60611-3055
Country	:	US
Telephone Number	:	312-926-2000
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/27/2018
Last Update Date	:	08/08/2022

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