Individual
KERRY DISANTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
908 N ELM ST, STE 110, HINSDALE, IL 60521-3635
(630) 986-8770
(630) 986-8776
Mailing address
1860 PAYSPHERE CIR, CHICAGO, IL 60674-0001
(630) 986-8770
(630) 986-8776
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
036-088886
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036-088886
—
IL
Enumeration date
06/21/2005
Last updated
08/24/2011
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