Individual
DR. DAVID A KANAREK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
RFD 4160, SUITE 304, LONG GROVE, IL 60047
(847) 634-2090
(847) 634-2140
Mailing address
RFD 4160, SUITE 304, LONG GROVE, IL 60047
(847) 634-2090
(847) 634-2140
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
036057417
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
004932170
BCBS PROVIDER #
IL
01
—
204843
MEDICARE PROVIDER #
IL
Enumeration date
07/03/2006
Last updated
07/09/2007
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