Individual
KENNETH PERTEET
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3269 W WABANSIA AVE, APT. #1, CHICAGO, IL 60647-4936
(773) 543-5140
(708) 575-9439
Mailing address
3269 W WABANSIA AVE, APT. #1, CHICAGO, IL 60647-4936
(773) 543-5140
(708) 575-9439
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
P63351178057
IL
Other
Enumeration date
06/20/2014
Last updated
06/20/2014
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