Organization
KINETIX MEDICAL WEIGHT LOSS AND WELLNESS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MONA LALA MD (DIRECTOR)
(773) 458-5586
Entity
Organization
Contact information
Practice address
742 N ADA ST UNIT 1S, CHICAGO, IL 60642-8615
(773) 270-8223
Mailing address
742 N ADA ST UNIT 1S, CHICAGO, IL 60642-8615
(773) 270-8223
Taxonomy
Speciality
Code
Description
License number
State
2083B0002X
Obesity Medicine (Preventive Medicine) Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1699716589
INDIVIDUAL NPI
—
Enumeration date
05/15/2019
Last updated
05/15/2019
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