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Individual

ANTOINETTE SALLAMME

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
9730 S WESTERN AVE STE 500, EVERGREEN PK, IL 60805-2780
(708) 425-7337
(708) 636-3485
Mailing address
9730 S WESTERN AVE STE 500, EVERGREEN PK, IL 60805-2780
(708) 425-7337
(708) 636-3485

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
036105336
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
336066513
CONTROLLED SUBSTANCE
IL
Enumeration date
12/04/2006
Last updated
04/20/2022
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