Individual
KENT T PERRY JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2160 S 1ST AVE, 101-1740 LOYOLA UNIVERSITY MEDICAL CENTER, MAYWOOD, IL 60153
(708) 216-9000
(708) 216-8472
Mailing address
2160 S 1ST AVE, 101-1740 LOYOLA UNIVERSITY MEDICAL CENTER, MAYWOOD, IL 60153
(708) 216-9000
(708) 216-8472
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
36097503
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
36097503
—
IL
Enumeration date
03/01/2006
Last updated
07/08/2007
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