Individual
DR. KEVIN P. GERMINO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
16660 107TH ST, ORLAND PARK, IL 60467-8898
(708) 403-8500
(708) 364-7080
Mailing address
PO BOX 713260, CHICAGO, IL 60677-1260
(630) 469-9200
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
036082588
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01630151
BCBS PROVIDER GROUP #
IL
05
—
036082588
—
IL
01
—
14D0991123
CLIA #
IL
01
—
4205297
AETNA PROVIDER#
IL
01
—
705600
MEDICARE GROUP #
IL
Enumeration date
07/27/2006
Last updated
08/08/2023
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