Provider Demographics
NPI:1104578384
Name:ALTEAS HEALTH PULMONARY INDIANA PC
Entity type:Organization
Organization Name:ALTEAS HEALTH PULMONARY INDIANA PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOEL
Authorized Official - Middle Name:C
Authorized Official - Last Name:OKNER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:847-769-0621
Mailing Address - Street 1:PO BOX 368
Mailing Address - Street 2:
Mailing Address - City:NORTHBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60065-0368
Mailing Address - Country:US
Mailing Address - Phone:847-386-7744
Mailing Address - Fax:
Practice Address - Street 1:1532 CALUMET AVE
Practice Address - Street 2:
Practice Address - City:DYER
Practice Address - State:IN
Practice Address - Zip Code:46311-1501
Practice Address - Country:US
Practice Address - Phone:866-227-3606
Practice Address - Fax:847-881-0838
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-19
Last Update Date:2023-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty