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Organization

KING, LTD

Active
Organization subpart
No

Provider details

NPI number
Authorized official
GARTRELL D KING M.D. (OWNER)
(773) 505-6120
Entity
Organization

Contact information

Practice address
9332 S VANDERPOEL AVE, CHICAGO, IL 60643-5852
(773) 505-6120
(847) 622-8048
Mailing address
9332 S VANDERPOEL AVE, CHICAGO, IL 60643-5852
(773) 505-6120
(847) 622-8048

Taxonomy

Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
036056245
IL
207R00000X
Internal Medicine Physician
Primary
036056245
IL

Other

Enumeration date
04/14/2010
Last updated
04/14/2010
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