MEDICARE: PETER C RANTIS M.D.

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	174400000X	Specialist	036085415	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1306806682
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PETER C RANTIS M.D.

Provider Business Mailing Address
First Line	:	4885 HOFFMAN BLVD
Second Line	:	SUITE 400
City	:	HOFFMAN ESTATES
State	:	IL
Zip	:	60192-3726
Country	:	US
Telephone Number	:	847-255-9697
Fax Number	:	847-255-3206

Provider Business Practice Location Address
First Line	:	4885 HOFFMAN BLVD
Second Line	:	SUITE 400
City	:	HOFFMAN ESTATES
State	:	IL
Zip	:	60192-3726
Country	:	US
Telephone Number	:	847-255-9697
Fax Number	:	847-255-3206

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

Provider Enumeration Date	:	03/23/2006
Last Update Date	:	10/18/2011

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