Individual
MR. KEN GABRIEL DOVERTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
1420 RENAISSANCE DR STE 207, PARK RIDGE, IL 60068-1342
(847) 296-6161
(847) 574-7444
Mailing address
1420 RENAISSANCE DR STE 207, PARK RIDGE, IL 60068-1342
(847) 296-6161
(847) 574-7444
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
209018290
IL
Other
Enumeration date
11/07/2018
Last updated
03/31/2022
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