Organization
KLEIN & SLOTTEN MEDICAL ASSOCIATES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MARY AMMONS (MANAGER)
(312) 280-0996
Entity
Organization
Contact information
Practice address
711 W NORTH AVE, STE 209, CHICAGO, IL 60610-1042
(312) 280-0996
(312) 280-8789
Mailing address
711 W NORTH AVE, STE 209, CHICAGO, IL 60610-1042
(312) 280-0996
(312) 280-8789
Taxonomy
Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
Primary
036059654
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036059654
—
IL
05
—
036064610
—
IL
05
—
036075827
—
IL
Enumeration date
07/22/2006
Last updated
07/29/2010
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