Individual
KENNETH CANDIDO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
836 W WELLINGTON AVE, SUITE 4815, CHICAGO, IL 60657-5147
(773) 296-7934
(773) 296-5088
Mailing address
509 RIDGEMOOR DR, WILLOWBROOK, IL 60527-5358
(847) 615-2200
(847) 615-2858
Taxonomy
Speciality
Code
Description
License number
State
208VP0014X
Interventional Pain Medicine Physician
Primary
36075131
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036075131
—
IL
Enumeration date
01/26/2006
Last updated
06/12/2014
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