Provider Demographics
NPI:1578563904
Name:PUTTERMAN, ALLEN M (MD)
Entity Type:Individual
Prefix:
First Name:ALLEN
Middle Name:M
Last Name:PUTTERMAN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:111 N WABASH AVE
Mailing Address - Street 2:STE 1722
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60602-1903
Mailing Address - Country:US
Mailing Address - Phone:312-372-2256
Mailing Address - Fax:312-372-1762
Practice Address - Street 1:111 N WABASH AVE
Practice Address - Street 2:STE 1722
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60602-1903
Practice Address - Country:US
Practice Address - Phone:312-372-2256
Practice Address - Fax:312-372-1762
Is Sole Proprietor?:No
Enumeration Date:2005-07-28
Last Update Date:2007-12-26
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IL207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1615355OtherBCBS PROVIDER NUMBER
IL1615355OtherBCBS PROVIDER NUMBER