Provider Demographics
NPI:1396035200
Name:ALTMAN, CLAUDIO G (PSYD)
Entity Type:Individual
Prefix:MR
First Name:CLAUDIO
Middle Name:G
Last Name:ALTMAN
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4611 N RAVENSWOOD AVE STE 105
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60640-7569
Mailing Address - Country:US
Mailing Address - Phone:773-414-0115
Mailing Address - Fax:
Practice Address - Street 1:4256 N. MOZART ST.
Practice Address - Street 2:APARTMENT #3N
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60618-1586
Practice Address - Country:US
Practice Address - Phone:773-414-0115
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-04-12
Last Update Date:2021-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071.008349103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical