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General NPI Number Information
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NPI Number | 1326308925
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Entity Type | Organization
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Legal Business Name | KAREN ALTAY MD LTD
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Dates
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Enumeration Date | 05/17/2012
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Last Update Date | 05/17/2012
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Provider Practice Location Address
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Address Line | 471 W ARMY TRAIL RD SUITE 105
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City | BLOOMINGDALE
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State | IL
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Zip | 60108-2673
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Country | US
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Telephone | 630-893-0900
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Fax | 630-893-0922
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Provider Business Mailing Address
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Address Line | 471 W ARMY TRAIL RD SUITE 105
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City | BLOOMINGDALE
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State | IL
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Zip | 60108-2673
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Country | US
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Telephone | 630-893-0900
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Fax | 630-893-0922
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. KAREN A ALTAY
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Credential | MD
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Telephone | 630-893-0900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 036.061735
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License Number State | IL
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