Healthcare Provider Details

I. General information

NPI: 1780336966
Provider Name (Legal Business Name): ALTEAS HEALTH CARDIOLOGY INDIANA PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/19/2022
Last Update Date: 10/31/2023
Certification Date: 10/31/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1532 CALUMET AVE
DYER IN
46311-1501
US

IV. Provider business mailing address

PO BOX 1541
NORTHBROOK IL
60065-1541
US

V. Phone/Fax

Practice location:
  • Phone: 866-227-3606
  • Fax: 847-881-0838
Mailing address:
  • Phone: 847-386-7744
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. JOEL OKNER
Title or Position: OWNER
Credential: MD
Phone: 847-769-0621