Individual
MR. KEVIN KISTNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
COMS
Contact information
Practice address
5000 S 5TH AVE, HINES, IL 60141-3030
(630) 202-2273
Mailing address
97 N OTT AVE, GLEN ELLYN, IL 60137-5633
(708) 202-2273
Taxonomy
Speciality
Code
Description
License number
State
156F00000X
Technician/Technologist
Primary
—
—
Other
Enumeration date
04/23/2015
Last updated
04/23/2015
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