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NPI Code Detail

MEDICARE: JEFFREY S ALTMAN MD

MEDICARE: JEFFREY S ALTMAN 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
1207N00000XDermatology Physician036085199IL

General Provider Information

NPI Number : 1831166958
Entity Type Code : Individual
Provider Name (Legal Business Name) : JEFFREY S ALTMAN MD
Provider Business Mailing Address
First Line : 2000 LAKE AVE
Second Line :
City : WOODSTOCK
State : IL
Zip : 60098-7401
Country : US
Telephone Number : 815-337-7100
Fax Number : 815-337-4793
Provider Business Practice Location Address
First Line : 2000 LAKE AVE
Second Line :
City : WOODSTOCK
State : IL
Zip : 60098-7401
Country : US
Telephone Number : 815-337-7100
Fax Number : 815-337-4793
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/07/2006
Last Update Date : 07/12/2016

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