Provider Demographics
NPI:1902072895
Name:RONALD F ALTMAN MD SC
Entity Type:Organization
Organization Name:RONALD F ALTMAN MD SC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:F
Authorized Official - Last Name:ALTMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:847-381-7171
Mailing Address - Street 1:27790 WEST HIGHWAY 22
Mailing Address - Street 2:SUITE #4
Mailing Address - City:BARRINGTON
Mailing Address - State:IL
Mailing Address - Zip Code:60010-2395
Mailing Address - Country:US
Mailing Address - Phone:847-381-7171
Mailing Address - Fax:847-381-2738
Practice Address - Street 1:27790 WEST HIGHWAY 22
Practice Address - Street 2:SUITE #4
Practice Address - City:BARRINGTON
Practice Address - State:IL
Practice Address - Zip Code:60010-2395
Practice Address - Country:US
Practice Address - Phone:847-381-7171
Practice Address - Fax:847-381-2738
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-01
Last Update Date:2008-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
C43275Medicare UPIN