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Individual

MR. KEVIN AUGUSTINE JOSEPH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
7110 W 127TH ST STE 130, PALOS HEIGHTS, IL 60463-1579
(708) 923-6300
(708) 923-6303
Mailing address
440 N MCCLURG CT, APT #409, CHICAGO, IL 60611-4370
(262) 844-8559

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
036139732
IL
390200000X
Student in an Organized Health Care Education/Training Program

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
036139732
IL
Enumeration date
03/19/2013
Last updated
01/06/2022
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