JOHN G LATALL (NPI# 1487630364) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1487630364 |
| Entity Type | Individual |
| Full Name | JOHN G LATALL |
| Credential | MD |
| Practice Address |
2073 N Clybourn Ave Chicago IL 60614-4003 |
| Practice Telephone | 7736654016 |
| Practice Fax Number | 7733606200 |
| Mailing Telephone | 7736654016 |
| Mailing Fax Number | 7733606200 |
| Enumeration Date | 2005-12-21 |
| Last Update Date | 2014-11-04 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207K00000X | Allergy & Immunology | 036-084430 | IL | Allopathic & Osteopathic Physicians |
| N | 207K00000X | Allergy & Immunology | 036084430 | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | BCBS OF IL | 01621679 | 01 |
| IL | 036084430 / 02 | 05 |
| Street Address |
2073 N CLYBOURN AVE |
| City | CHICAGO |
| State | IL |
| Zip Code | 60614-4003 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295729887 | Jennifer B Hartman | Nurse Practitioner | 2073 N Clybourn Ave, Chicago, IL 60614-4003 | 2005-09-09 |
| 1053836783 | Bianca Alexandria Doherty | Physician Assistant | 2073 N Clybourn Ave, Chicago, IL 60614-4003 | 2017-08-03 |
| 1538457759 | Kinzie G. Sharp | Physician Assistant | 2073 N Clybourn Ave, Chicago, IL 60614-4003 | 2011-07-21 |
| 1518951185 | Howard Monroe Rice | Pediatrics | 2073 N Clybourn Ave, Chicago, IL 60614-4003 | 2005-09-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487266516 | Taylor Connington | Pharmacist | 843 W Armitage Ave, Chicago, IL 60614 | 2020-08-19 |
| 1356975692 | Amarilis Diaz | Social Worker | Terry Hefter Associates, LLC, 1731 N. Marcey Suite 535, Chicago, IL 60614 | 2020-02-25 |
| 1457902975 | Michele Waggoner | Physical Therapist | 2515 N. Clark St, Chicago, IL 60614 | 2019-09-25 |
| 1669031936 | Justin Pomeroy | Acupuncturist | 1350 W. Schubert Ave., Chicago, IL 60614 | 2019-06-11 |
| 1801451547 | Amanda Harris | Counselor | 2451 N Lincoln Ave # 206, Chicago, IL 60614 | 2019-05-08 |
| 1780164574 | Danielle Trokey | Psychiatry & Neurology | 2515 N Clark St Ste 801, Chicago, IL 60614 | 2018-08-21 |
| 1841707353 | Madison Counseling Solutions LLC | Social Worker | 2502 N. Clark St., Chicago, IL 60614 | 2018-01-05 |
| 1386154011 | Allison Cooper Boyan | Occupational Therapist | 1640 N. Wells St., Unit 103, Chicago, IL 60614 | 2017-10-09 |
| 1245759653 | Eileen Davidson Siegel | Physician Assistant | 2073 N. Clybourn Ave., Chicago, IL 60614 | 2017-09-18 |
| 1447779814 | Elizabeth Hobart | Psychologist | 1800 W. Diversey Pkwy, Unit H, Chicago, IL 60614 | 2017-09-16 |
| Find all providers in zip 60614 | ||||
| Taxonomy Code | 207K00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Allergy & Immunology |
| An allergist-immunologist is trained in evaluation, physical and laboratory diagnosis, and management of disorders involving the immune system. Selected examples of such conditions include asthma, anaphylaxis, rhinitis, eczema, and adverse reactions to drugs, foods, and insect stings as well as immune deficiency diseases (both acquired and congenital), defects in host defense, and problems related to autoimmune disease, organ transplantation, or malignancies of the immune system. |
| Notes: Source: American Board of Medical Specialties, 2007, www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Allergy and Immunology, 2007. http://www.abai.org/ No subspecialty certificates in allergy and immunology are offered by the American Board of Allergy and Immunology (ABAI). The ABAI, however, does offer formal special pathways for physicians seeking dual certification in allergy/immunology and pediatric pulmonology; allergy/immunology and pediatric rheumatology; and allergy/immunology and adult rheumatology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275063695 | Chicago Allergy & Asthma, LLC | Allergy & Immunology | 7447 W Talcott Ave Ste 308, Chicago, IL 60631-3714 | 2017-06-18 |
| 1982022810 | Kirk Van Shepard II | Allergy & Immunology | 3000 N Halsted St Ste 400, Chicago, IL 60657-8480 | 2014-03-28 |
| 1558794446 | Sarah M Boudreau-romano | Allergy & Immunology | 1300 N Lake Shore Dr Apt 3a, Chicago, IL 60610-2157 | 2013-08-14 |
| 1821420209 | Donald Ernest Temple | Allergy & Immunology | 110 E Delaware Pl, Chicago, IL 60611-1481 | 2013-08-07 |
| 1871859645 | Sarah Garon | Allergy & Immunology | 1460 N Halsted St Ste 506, Chicago, IL 60642-2605 | 2012-04-06 |
| 1548572670 | Payal Dilip Patel | Allergy & Immunology | 1411 S Michigan Ave, Chicago, IL 60605 | 2010-07-06 |
| 1902117302 | David Aaron Nayak | Allergy & Immunology | 530 N Lake Shore Dr, Apt 807, Chicago, IL 60611-7424 | 2010-06-30 |
| 1821246646 | Abhilasha Ganju | Allergy & Immunology | 1286 N Milwaukee Ave # 205, Chicago, IL 60642-2219 | 2008-09-04 |
| 1891956090 | Michael Rosenberg | Allergy & Immunology | 150 W Superior St, Unit 1101, Chicago, IL 60610-8710 | 2008-06-19 |
| 1265502231 | Bienvenido Tecson Lamorena | Allergy & Immunology | 5356 W Diversey Ave, Chicago, IL 60639-1513 | 2006-11-08 |
| Find all providers in CHICAGO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.