Individual
KRISTINA MARIE POTANOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
220 S PARK AVE FL 3, HERRIN, IL 62948-3602
(618) 942-2002
(618) 351-6497
Mailing address
PO BOX 3988, CARBONDALE, IL 62902-3988
(618) 457-5200
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
036141342
IL
Other
Enumeration date
04/18/2008
Last updated
07/01/2024
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