Provider Demographics
NPI:1760524110
Name:PLATT, HARRY R (MD)
Entity Type:Individual
Prefix:
First Name:HARRY
Middle Name:R
Last Name:PLATT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:620 WILDWOOD DR
Mailing Address - Street 2:
Mailing Address - City:JOLIET
Mailing Address - State:IL
Mailing Address - Zip Code:60431-4891
Mailing Address - Country:US
Mailing Address - Phone:815-741-3395
Mailing Address - Fax:815-741-3313
Practice Address - Street 1:620 WILDWOOD DR
Practice Address - Street 2:
Practice Address - City:JOLIET
Practice Address - State:IL
Practice Address - Zip Code:60431-4891
Practice Address - Country:US
Practice Address - Phone:815-741-3395
Practice Address - Fax:815-741-3313
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-13
Last Update Date:2008-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology