Amenta, Charles Anthony

Amenta, Charles Anthony is an sole proprietor health care provider with primary practice located at 18161 Morris Ave Suite 105, Homewood IL 60430-2108. He recently has only one registered license in Other Service Providers / Specialist, which is considered as his primary health care specialty. Amenta, Charles Anthony can be contacted via phone (708) 799-5520.

Contact Information

Primary practice address
18161 Morris Ave Suite 105 Homewood IL 60430-2108
Phone: (708) 799-5520
Fax: (708) 799-5358
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X 036075600 Illinois

Profile Details

NPI number 1467444620
LBN Legal business name Amenta, Charles Anthony
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 15th, 2005
Last updated Dec 14th, 2021 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1467444620 NPPES
Illinois MEDICAID 036075600
Illinois Other 040010012
Illinois Other 05055067
Illinois Other 01606798

Popular Providers