Individual
KENNETH PORTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
15505 127TH ST, LEMONT, IL 60439-4433
(630) 257-2265
Mailing address
15505 127TH ST, LEMONT, IL 60439-4433
(630) 257-2265
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
036-074508
IL
Other
Enumeration date
08/21/2006
Last updated
01/26/2011
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