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Individual

WILLIAM A KCOMT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
5201 S. WILLOW SPRINGS ROAD, SUITE 450, LA GRANGE, IL 60525
(716) 346-7645
Mailing address
1616 E 56TH ST UNIT 707, CHICAGO, IL 60637-2706

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
01057051A
IN
207RR0500X
Rheumatology Physician
01057051A
IN
207RR0500X
Rheumatology Physician
Primary
180005257
IL
207RR0500X
Rheumatology Physician
MD424246
PA
208M00000X
Hospitalist Physician
01057051A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1010426340002
PA
Enumeration date
08/11/2005
Last updated
09/18/2018
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