Provider Demographics
NPI:1649800012
Name:ATTONITO, JOHN DANIEL (MD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:DANIEL
Last Name:ATTONITO
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3420 ILLINOIS STREET
Mailing Address - Street 2:TRANQUILITY CLINIC - SPECIAL PHYSICALS
Mailing Address - City:GREAT LAKES
Mailing Address - State:IL
Mailing Address - Zip Code:60088
Mailing Address - Country:US
Mailing Address - Phone:847-688-6755
Mailing Address - Fax:847-688-2721
Practice Address - Street 1:3420 ILLINOIS STREET
Practice Address - Street 2:TRANQUILLITY CLINIC - SPECIAL PHYSICALS
Practice Address - City:GREAT LAKES
Practice Address - State:IL
Practice Address - Zip Code:60088
Practice Address - Country:US
Practice Address - Phone:847-688-6755
Practice Address - Fax:847-688-2721
Is Sole Proprietor?:No
Enumeration Date:2020-01-24
Last Update Date:2025-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036.167685207Q00000X, 171000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171000000XOther Service ProvidersMilitary Health Care Provider
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine