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Individual

DR. OLIVIA KISMARTONI

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DVM, MPH

Contact information

Practice address
530 DUNHAM RD, ST CHARLES, IL 60174-1404
(630) 584-7404
Mailing address
60 W TERRA COTTA AVE # B284, CRYSTAL LAKE, IL 60014-3548
(312) 622-6880

Taxonomy

Speciality
Code
Description
License number
State
174M00000X
Veterinarian
Primary
090.010466
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
090.010466
VETERINARY LICENSE NUMBER
IL
Enumeration date
02/16/2012
Last updated
02/16/2012
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