Provider Demographics
NPI:1992731582
Name:LOITERMAN, DAVID A (MD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:A
Last Name:LOITERMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:7 N. GRANT STREET
Mailing Address - Street 2:1ST FLOOR
Mailing Address - City:HINSDALE
Mailing Address - State:IL
Mailing Address - Zip Code:60521
Mailing Address - Country:US
Mailing Address - Phone:708-354-8881
Mailing Address - Fax:708-354-8340
Practice Address - Street 1:7 N. GRANT STREET
Practice Address - Street 2:1ST FLOOR
Practice Address - City:HINSDALE
Practice Address - State:IL
Practice Address - Zip Code:60521-3366
Practice Address - Country:US
Practice Address - Phone:708-354-8881
Practice Address - Fax:708-354-8340
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-24
Last Update Date:2011-07-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL036-0686022086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036068602Medicaid
020026349OtherMEDICARE RAILROAD
IL022-01663OtherBLUE CROSS BLUE SHIELD
762641Medicare PIN
ILC39413Medicare UPIN
IL036068602Medicaid