Individual
KANETHA TENNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2817 LEDGESTONE CT, NAPERVILLE, IL 60564-8444
(630) 728-4988
Mailing address
P O BOX 9222, NAPERVILLE, IL 60564-8444
(630) 728-4988
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
—
—
Other
Enumeration date
09/15/2016
Last updated
08/17/2017
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