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1902301138

NPI Code Detail

MEDICARE: NATHALIE ANTONIOS MD

MEDICARE: NATHALIE ANTONIOS 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	207RC0200X	Critical Care Medicine (Internal Medicine) Physician	036156686	IL
2	207RP1001X	Pulmonary Disease Physician	036156686	IL
3	208M00000X	Hospitalist Physician	036156686	IL

General Provider Information

NPI Number	:	1902301138
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NATHALIE ANTONIOS MD

Provider Business Mailing Address
First Line	:	150 HARVESTER DR STE 300
Second Line	:
City	:	BURR RIDGE
State	:	IL
Zip	:	60527-5965
Country	:	US
Telephone Number	:	773-702-1150
Fax Number	:

Provider Business Practice Location Address
First Line	:	5841 S MARYLAND AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60637-1443
Country	:	US
Telephone Number	:	773-702-1000
Fax Number	:

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

Provider Enumeration Date	:	03/28/2018
Last Update Date	:	02/06/2026

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Directions to “ NATHALIE ANTONIOS 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.

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