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General NPI Number Information
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NPI Number | 1720277791
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Entity Type | Organization
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Legal Business Name | DANTE A. PIMENTEL, M.D., S.C.
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Dates
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Enumeration Date | 10/16/2007
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Last Update Date | 10/16/2007
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Provider Practice Location Address
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Address Line | 6032 S HALSTED ST # 102
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City | CHICAGO
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State | IL
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Zip | 60621-2112
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Country | US
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Telephone | 773-651-9200
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Fax | 773-651-9203
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Provider Business Mailing Address
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Address Line | 6032 S HALSTED ST # 102
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City | CHICAGO
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State | IL
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Zip | 60621-2112
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Country | US
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Telephone | 773-651-9200
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Fax | 773-651-9203
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. DANTE ANTHONY PIMENTEL
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Credential | M.D.
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Telephone | 773-651-9200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State | IL
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