Individual
ANTRONE MCINTOSH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
409 WATSEKA ST, PARK FOREST, IL 60466-1307
(773) 648-3680
Mailing address
409 WATSEKA ST, PARK FOREST, IL 60466-1307
(773) 648-3680
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
M25301084253
IL
Other
Enumeration date
10/25/2023
Last updated
10/25/2023
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