| Doctor Name: | DR. MARIE MYRLANDE KERNIZAN |
| NPI Number: | 1326238585 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | M.D. |
| License Number: | 036099858 |
| Business Practice Address: | 9625 S Colfax Ave Chicago, IL - 606174900 |
| Business Phone Number: | 7734838400 |
| Business Fax Number: | |
| Mailing Address: | 8349 S Baltimore Ave, CHICAGO |
| State: | IL |
| Postal Code: | 606172110 |
| Phone Number: | 7739785291 |
| Fax Number: | |
| NPI Enumeration Date: | 07/25/2007 |
| NPI Last Update Date: | 08/03/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 036099858 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |