Individual
JULIET IBANEZ PANAMBO KANTOFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGPCNP
Contact information
Practice address
401 N MICHIGAN AVE STE 1200, CHICAGO, IL 60611-4264
(312) 635-0973
Mailing address
3946 N RAVENSWOOD AVE APT 408, CHICAGO, IL 60613-5679
(312) 208-4962
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
209012519
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
209.012519
STATE LICENSE APN
IL
Enumeration date
07/07/2015
Last updated
08/02/2024
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