Kaczor, David E
Kaczor, David E is an individual health care provider with primary practice located at 4727 Willow Springs Road , Lagrange IL 60525. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Kaczor, David E can be contacted via phone (708) 588-0088.Contact Information
Primary practice address
4727 Willow Springs Road
Lagrange IL 60525
Phone: (708) 588-0088
Fax: (708) 588-0588
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | Illinois |
Profile Details
| NPI number | 1053491662 |
|---|---|
| LBN Legal business name | Kaczor, David E |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 17th, 2006 |
| Last updated | Jul 8th, 2007 - about 17 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1053491662 | NPPES |
| Illinois | Other | 01632115 | BLUE SHIELD |
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