Antoo, Alby K
Antoo, Alby K is an individual health care provider with primary practice located at 10400 75Th St , Kenosha WI 53142. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Antoo, Alby K can be contacted via phone (262) 948-6740.Contact Information
Primary practice address
10400 75Th St
Kenosha WI 53142
Phone: (262) 948-6740
Fax: (262) 948-6721
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 036-113334 | Illinois |
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 48314 | Wisconsin |
Profile Details
| NPI number | 1407864093 |
|---|---|
| LBN Legal business name | Antoo, Alby K |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 3rd, 2006 |
| Last updated | Oct 18th, 2023 - about last year |
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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1407864093 | NPPES |
| Wisconsin | MEDICAID | 34661500 |
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