Doctor Name: | DEBORAH JEAN KANTORIS |
NPI Number: | 1013266352 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | APN |
License Number: | 209009684 |
Business Practice Address: | 1775 Dempster Street Park Ridge, IL - 60068 |
Business Phone Number: | 8477238308 |
Business Fax Number: | |
Mailing Address: | 1775 Dempster Street, PARK RIDGE |
State: | IL |
Postal Code: | 60068 |
Phone Number: | 8477238308 |
Fax Number: | |
NPI Enumeration Date: | 08/31/2012 |
NPI Last Update Date: | 08/31/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 364SA2100X |
License Number: | 209009684 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Clinical Nurse Specialist |
Taxonomy Specialization: | Acute Care |
Taxonomy Definition: |