Provider Demographics
NPI:1275588824
Name:ALLERGY EAR NOSE THROAT,LTD
Entity Type:Organization
Organization Name:ALLERGY EAR NOSE THROAT,LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANGELO
Authorized Official - Middle Name:ROBERT
Authorized Official - Last Name:CONSIGLIO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:630-675-6700
Mailing Address - Street 1:2320 DEAN ST STE 103
Mailing Address - Street 2:
Mailing Address - City:ST CHARLES
Mailing Address - State:IL
Mailing Address - Zip Code:60175-1068
Mailing Address - Country:US
Mailing Address - Phone:630-377-0106
Mailing Address - Fax:630-377-1186
Practice Address - Street 1:1034 WARREN AVE
Practice Address - Street 2:
Practice Address - City:DOWNERS GROVE
Practice Address - State:IL
Practice Address - Zip Code:60515-3601
Practice Address - Country:US
Practice Address - Phone:630-969-9200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-23
Last Update Date:2008-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyGroup - Multi-Specialty
No207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Multi-Specialty