Provider Demographics
NPI:1063852556
Name:PLAMOOTTIL, ANN ISSAC (MD)
Entity Type:Individual
Prefix:DR
First Name:ANN
Middle Name:ISSAC
Last Name:PLAMOOTTIL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7435 W TALCOTT AVE
Mailing Address - Street 2:RESURRECTION EM RESIDENCY
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60631-3707
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:102 E CULVER RD
Practice Address - Street 2:
Practice Address - City:KNOX
Practice Address - State:IN
Practice Address - Zip Code:46534-2216
Practice Address - Country:US
Practice Address - Phone:574-772-6231
Practice Address - Fax:574-772-2885
Is Sole Proprietor?:No
Enumeration Date:2013-06-27
Last Update Date:2019-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL125063475207P00000X
IN01082221A207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine