Provider Demographics
NPI:1053081810
Name:ALTEAS HEALTH PULMONARY OF WISCONSIN S.C.
Entity Type:Organization
Organization Name:ALTEAS HEALTH PULMONARY OF WISCONSIN S.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOEL
Authorized Official - Middle Name:C
Authorized Official - Last Name:OKNER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:847-769-0621
Mailing Address - Street 1:PO BOX 368
Mailing Address - Street 2:
Mailing Address - City:NORTHBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60065-0368
Mailing Address - Country:US
Mailing Address - Phone:847-386-7744
Mailing Address - Fax:847-881-0838
Practice Address - Street 1:301 S BEDFORD ST STE 1
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53703-3691
Practice Address - Country:US
Practice Address - Phone:847-386-7744
Practice Address - Fax:847-881-0838
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-14
Last Update Date:2021-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty