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Organization
PAUL M KENTOR MD SC
Active
Organization
PAUL M KENTOR MD SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PAUL M KENTOR MD (PHYSICIAN)
(847) 634-1690
Entity
Organization
Contact information
Practice address
580 ROGER WILLIAMS AVE STE 25, HIGHLAND PARK, IL 60035-4820
(847) 634-1690
(847) 634-1841
Mailing address
580 ROGER WILLIAMS AVE STE 25, HIGHLAND PARK, IL 60035-4820
(847) 634-1690
(847) 634-1841
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
Primary
036044332
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
210357
GROUP
IL
01
—
DG7085
RR MCR PTAN
IL
01
—
IL8708
MCR GROUP PTAN
IL
01
—
K12415
MCR IND PTAN
IL
Enumeration date
04/04/2007
Last updated
10/13/2023
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