John G Latall MD SC

Primary specialty

Allergy PhysicianTaxonomy code 207KA0200X

Legal business name

JOHN G LATALL MD SC

Doing business as

Premier Allergy, Asthma and Sinus SC

Practice address

2073 N Clybourn Ave
Chicago, IL 60614-4003

Phone

(773) 665-4016

Fax

(773) 360-6200

NPI assigned

Apr 4, 2012

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. John G Latall, M.D.NPI 1487630364

Title

President

Phone

(773) 665-4016

Specialties & licenses 2

Addresses

Other names 1

• Premier Allergy, Asthma and Sinus SC Doing business as

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• John G Latall, MD

  • Allergy & Immunology Physician
  • Chicago, IL
  • NPI 1487630364
  Medicare reassignment NPD Authorized official
• Emily Reinwald

  • Physician Assistant
  • Chicago, IL
  • NPI 1669289005
  Medicare reassignment NPD
• Jessica Lauren Jakob

  • Physician Assistant
  • Chicago, IL
  • NPI 1386040400
  Medicare reassignment

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1333497600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1664928000000",
    "number": "1134485055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2073 N CLYBOURN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606144003",
            "telephone_number": "773-665-4016",
            "fax_number": "773-665-0403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2073 N CLYBOURN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606144003",
            "telephone_number": "773-665-4016",
            "fax_number": "773-360-6200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 N. LaSalle St.",
            "address_2": "Ste 1130",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "60602",
            "country_code": "US",
            "telephone_number": "312-796-2241",
            "fax_number": "312-796-2333",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4905 Old Orchard Ctr Lowr Level",
            "address_purpose": "LOCATION",
            "city": "Skokie",
            "state": "IL",
            "postal_code": "600771458",
            "country_code": "US",
            "telephone_number": "773-665-4016",
            "fax_number": "773-360-6200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "JOHN G LATALL MD SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-04",
        "last_updated": "2022-10-05",
        "certification_date": "2022-10-05",
        "status": "A",
        "authorized_official_last_name": "LATALL",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "773-665-4016",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207KA0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Allergy & Immunology, Allergy",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "IL",
            "license": "036-084430",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Premier Allergy, Asthma and Sinus SC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Premier Allergy, Asthma and Sinus SC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Allergy Physician in Chicago, IL
• Providers in Chicago, IL by specialty
• Allergy Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.