MEDICARE: JOHN G LATALL MD

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	207K00000X	Allergy & Immunology Physician	036084430	IL
2	207K00000X	Allergy & Immunology Physician	036-084430	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
2	01621679	OTHER	IL	BCBS OF IL

General Provider Information

NPI Number	:	1487630364
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOHN G LATALL MD

Provider Business Mailing Address
First Line	:	2073 N CLYBOURN AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60614-4003
Country	:	US
Telephone Number	:	773-665-4016
Fax Number	:	773-360-6200

Provider Business Practice Location Address
First Line	:	2073 N CLYBOURN AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60614-4003
Country	:	US
Telephone Number	:	773-665-4016
Fax Number	:	773-360-6200

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

Provider Enumeration Date	:	12/21/2005
Last Update Date	:	12/14/2021

Similar Medicare Providers

1235094681 — MARGARET CLARE DOUGHERTY
Practice Location Address:

2073 N CLYBOURN AVE
CHICAGO, IL
60614-4003

Practice Phone: 773-665-4016
Practice Fax:

1275618589 — DR. JOY H. GOFFRON-KLUGE O.D.
Practice Location Address:

2057 N CLYBOURN AVE
CHICAGO, IL
60614-4003

Practice Phone: 773-477-3475
Practice Fax:

1700946712 — FOR EYES
Practice Location Address:

2057 N CLYBOURN AVE
CHICAGO, IL
60614-4003

Practice Phone: 773-477-3475
Practice Fax: 773-477-8773

1225199565 — DR. DAWN M. LEE O.D.
Practice Location Address:

2057 N CLYBOURN AVE
CHICAGO, IL
60614-4003

Practice Phone: 773-477-3475
Practice Fax: 773-477-8773

1457416844 — DR. EVE N. ARNOLD O.D.
Practice Location Address:

2057 N CLYBOURN AVE
CHICAGO, IL
60614-4003

Practice Phone: 773-477-3475
Practice Fax: 773-477-4380

1023165362 — MADHAVI S DESHMUKH PA-C
Practice Location Address:

2077 N CLYBOURN AVE
CHICAGO, IL
60614-4003

Practice Phone: 773-886-1500
Practice Fax:

Directions to “ JOHN G LATALL MD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.