Individual
KAITLIN WANTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
17495 LA GRANGE RD, TINLEY PARK, IL 60487-7581
(630) 717-2600
Mailing address
PO BOX 713260, CHICAGO, IL 60677-1260
(630) 469-9200
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
036-140709
IL
Other
Enumeration date
03/25/2013
Last updated
10/04/2024
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