Provider Demographics
NPI:1194912220
Name:KANTER, ALAN MARC (MD)
Entity type:Individual
Prefix:DR
First Name:ALAN
Middle Name:MARC
Last Name:KANTER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:116 E ROCKWELL ST
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60005-2622
Mailing Address - Country:US
Mailing Address - Phone:847-463-6464
Mailing Address - Fax:
Practice Address - Street 1:455 S ROSELLE RD
Practice Address - Street 2:
Practice Address - City:SCHAUMBURG
Practice Address - State:IL
Practice Address - Zip Code:60193-2971
Practice Address - Country:US
Practice Address - Phone:630-671-4980
Practice Address - Fax:630-671-4989
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-02
Last Update Date:2019-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036086944207Q00000X
WI51172-20207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILF84997Medicare UPIN