Individual
KARL KETTELHUT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
701 W NORTH AVE, MELROSE PARK, IL 60160-1612
(708) 681-3200
Mailing address
PO BOX 3613, CAROL STREAM, IL 60132-3613
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
209022754
IL
Other
Enumeration date
02/09/2021
Last updated
02/09/2021
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