Healthcare Provider Details

I. General information

NPI: 1346491941
Provider Name (Legal Business Name): DINA KANER, M.D., S.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/02/2008
Last Update Date: 10/02/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3385 N ARLINGTON HEIGHTS RD SUITE A
ARLINGTON HEIGHTS IL
60004-7702
US

IV. Provider business mailing address

3385 N ARLINGTON HEIGHTS RD SUITE A
ARLINGTON HEIGHTS IL
60004-7702
US

V. Phone/Fax

Practice location:
  • Phone: 847-632-0600
  • Fax: 847-632-0604
Mailing address:
  • Phone: 847-632-0600
  • Fax: 847-632-0604

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number036092768
License Number StateIL

VIII. Authorized Official

Name: DR. DINA KANER
Title or Position: OWNER / PHYSICIAN
Credential: M.D.
Phone: 847-632-0600