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NPI Code Detail

MEDICARE: DR. MARIE T ALTIMARI M.D.

MEDICARE: DR. MARIE T ALTIMARI 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
1207Q00000XFamily Medicine Physician036118100IL

Other Identifiers

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

General Provider Information

NPI Number : 1538375530
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MARIE T ALTIMARI M.D.
Provider Business Mailing Address
First Line : 4445 W IRVING PARK RD
Second Line :
City : CHICAGO
State : IL
Zip : 60641-2808
Country : US
Telephone Number : 312-926-3627
Fax Number :
Provider Business Practice Location Address
First Line : 4445 W IRVING PARK RD
Second Line :
City : CHICAGO
State : IL
Zip : 60641-2808
Country : US
Telephone Number : 312-926-3627
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/15/2007
Last Update Date : 05/29/2024

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