Provider Demographics
NPI:1922250141
Name:APANTAKU CLINICS LTD
Entity Type:Organization
Organization Name:APANTAKU CLINICS LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:
Authorized Official - Last Name:APANTAKU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:773-342-1212
Mailing Address - Street 1:2222 W DIVISION ST
Mailing Address - Street 2:SUITE # 320
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60622-2717
Mailing Address - Country:US
Mailing Address - Phone:773-342-1212
Mailing Address - Fax:773-342-1010
Practice Address - Street 1:2222 W DIVISION ST
Practice Address - Street 2:SUITE # 320
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60622-2717
Practice Address - Country:US
Practice Address - Phone:773-342-1212
Practice Address - Fax:773-342-1010
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-21
Last Update Date:2010-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-055818208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL747180Medicare PIN