Provider Demographics
NPI:1780066159
Name:APANTAKU, ELORA K (MD, MPH)
Entity type:Individual
Prefix:
First Name:ELORA
Middle Name:K
Last Name:APANTAKU
Suffix:
Gender:F
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3329 N AVERS AVE APT 3N
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60618-9737
Mailing Address - Country:US
Mailing Address - Phone:312-405-9787
Mailing Address - Fax:
Practice Address - Street 1:3329 N AVERS AVE APT 3N
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60618-9737
Practice Address - Country:US
Practice Address - Phone:312-405-9787
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-22
Last Update Date:2023-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA3327582083P0901X
IL036.1665372083P0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive Medicine