Healthcare Provider Details

I. General information

NPI: 1528079563
Provider Name (Legal Business Name): ALLAN H PALATNICK OD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/11/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

620 DUNDEE AVE
EAST DUNDEE IL
60118-3010
US

IV. Provider business mailing address

307 HICKORY LN
SCHAUMBURG IL
60193-1516
US

V. Phone/Fax

Practice location:
  • Phone: 847-426-5251
  • Fax: 847-426-5286
Mailing address:
  • Phone: 847-891-3992
  • Fax: 847-426-5286

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: