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Organization

LEMONT PRIMARY CARE, SC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
KENNETH PORTER MD (PRESIDENT)
(630) 257-2265
Entity
Organization

Contact information

Practice address
15505 127TH ST, LEMONT, IL 60439-4433
(630) 257-2265
Mailing address
15505 127TH ST, LEMONT, IL 60439-4433
(630) 257-2265

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
208000000X
Pediatrics Physician

Other

Enumeration date
08/21/2006
Last updated
12/31/2024
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