Individual
DR. KENNETH MARK SISTINO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
2229 W CHICAGO AVE, CHICAGO, IL 60622-4828
(773) 862-4500
(773) 862-4517
Mailing address
2229 W CHICAGO AVE, CHICAGO, IL 60622-4828
(773) 862-4500
(773) 862-4517
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
038-006195
IL
Other
Enumeration date
09/24/2011
Last updated
09/24/2011
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