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Organization
DR. KANIA FAMILY CARE, S.C.
Active
Organization
DR. KANIA FAMILY CARE, S.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AGNIESZKA KANIA M.D. (PHYSICIAN /OWNER)
(708) 655-5099
Entity
Organization
Contact information
Practice address
770 E NORTHWEST HWY, MOUNT PROSPECT, IL 60056-3464
(708) 655-5099
(708) 865-7099
Mailing address
8650 PALMER ST, RIVER GROVE, IL 60171-1908
(708) 655-5099
(708) 865-7099
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
03611597
IL LICENSE /CERTIFICATION
IL
01
—
215294
MEDICARE GROUP
IL
Enumeration date
09/28/2007
Last updated
02/01/2008
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