Organization
KIM M CARNAZZOLA MD SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KIM M CARNAZZOLA MD (PRESIDENT)
(847) 996-0607
Entity
Organization
Contact information
Practice address
1860 W WINCHESTER RD, SUITE 109, LIBERTYVILLE, IL 60048-5351
(847) 996-0607
(847) 996-0608
Mailing address
1860 W WINCHESTER RD, SUITE 109, LIBERTYVILLE, IL 60048-5351
(847) 996-0607
(847) 996-0608
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036085955
IL
Other
Enumeration date
03/15/2011
Last updated
04/19/2012
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