Provider Demographics
NPI:1447448790
Name:ALLEN M. PUTTERMAN, M.D., S.C.
Entity type:Organization
Organization Name:ALLEN M. PUTTERMAN, M.D., S.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ALLEN
Authorized Official - Middle Name:M
Authorized Official - Last Name:PUTTERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:312-372-2256
Mailing Address - Street 1:111 N WABASH AVE
Mailing Address - Street 2:SUITE 1722
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60602-1903
Mailing Address - Country:US
Mailing Address - Phone:312-372-2256
Mailing Address - Fax:312-372-1762
Practice Address - Street 1:111 N WABASH AVE
Practice Address - Street 2:SUITE 1722
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60602-1903
Practice Address - Country:US
Practice Address - Phone:312-372-2256
Practice Address - Fax:312-372-1762
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-11
Last Update Date:2007-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL2086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1615355OtherBCBD PROVIDER NUMBER
IL1615355OtherBCBD PROVIDER NUMBER