Healthcare Provider Details

I. General information

NPI: 1518459759
Provider Name (Legal Business Name): KANTAR MEDICAL CONSULTANTS SC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/04/2018
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1051 ESSINGTON RD STE 290
JOLIET IL
60435-2842
US

IV. Provider business mailing address

1051 ESSINGTON RD STE 290
JOLIET IL
60435-2842
US

V. Phone/Fax

Practice location:
  • Phone: 815-773-7827
  • Fax: 815-254-8442
Mailing address:
  • Phone: 815-773-7827
  • Fax: 815-254-8442

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code207QG0300X
TaxonomyGeriatric Medicine (Family Medicine) Physician
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: MOUHANNAD KANTAR
Title or Position: OWNER
Credential: MD
Phone: 702-308-6892