Organization
FELISMENO G KINTANAR, MD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FELISMENO G KINTANAR MD (OWNER)
(773) 254-6611
Entity
Organization
Contact information
Practice address
1952 W CERMAK RD, CHICAGO, IL 60608-4204
(773) 254-6611
(773) 254-8590
Mailing address
1952 W CERMAK RD, CHICAGO, IL 60608-4204
(773) 254-6611
(773) 254-8590
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036046196
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036046196
—
IL
Enumeration date
05/06/2009
Last updated
05/06/2009
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