Individual
DR. ALI KUTOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
9115 S CICERO AVE, OAK LAWN, IL 60453-1895
(708) 229-0300
(708) 229-0303
Mailing address
9115 S CICERO AVE, OAK LAWN, IL 60453-1895
(708) 229-0300
(708) 229-0303
Taxonomy
Speciality
Code
Description
License number
State
207RI0011X
Interventional Cardiology Physician
Primary
036076049
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036076049
—
IL
01
—
1605276
BCBS
IL
05
—
200094400A
—
IN
Enumeration date
02/17/2006
Last updated
08/16/2011
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