Provider Demographics
NPI:1063659928
Name:ALTMAN, IGOR (DO)
Entity Type:Individual
Prefix:
First Name:IGOR
Middle Name:
Last Name:ALTMAN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:840 S WOOD ST # MC958
Mailing Address - Street 2:UIMC -- VASCULAR SURGERY DIVISION, SUITE 376N
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60612-4325
Mailing Address - Country:US
Mailing Address - Phone:312-996-8459
Mailing Address - Fax:312-355-3722
Practice Address - Street 1:840 S WOOD ST # MC958
Practice Address - Street 2:UIMC -- VASCULAR SURGERY DIVISION
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60612-4325
Practice Address - Country:US
Practice Address - Phone:312-996-8459
Practice Address - Fax:312-355-3722
Is Sole Proprietor?:No
Enumeration Date:2009-01-14
Last Update Date:2010-09-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAOT012311207Q00000X
IL036.126214207Q00000X
PAOS014690207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine