Individual
KEVIN J EMBACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2160 S 1ST AVE, LOYOLA UNIV. HOSPITAL, ROOM 7604, MAYWOOD, IL 60153-3328
(708) 216-8757
(708) 216-1259
Mailing address
2160 S 1ST AVE, LOYOLA UNIV. HOSPITAL, ROOM 7604, MAYWOOD, IL 60153-3328
(708) 216-8757
(708) 216-1259
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
036126913
IL
207R00000X
Internal Medicine Physician
4301051783
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2801074
—
MI
Enumeration date
08/15/2005
Last updated
03/11/2011
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