Healthcare Provider Details

I. General information

NPI: 1750557674
Provider Name (Legal Business Name): K MEDICAL GROUP LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/30/2008
Last Update Date: 04/30/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8170 MCCORMICK BLVD SUITE 204
SKOKIE IL
60076-2961
US

IV. Provider business mailing address

8170 MCCORMICK BLVD SUITE 204
SKOKIE IL
60076-2961
US

V. Phone/Fax

Practice location:
  • Phone: 847-410-2029
  • Fax: 847-410-2041
Mailing address:
  • Phone: 847-410-2029
  • Fax: 847-410-2041

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code173000000X
TaxonomyLegal Medicine
License Number336013688
License Number StateIL

VIII. Authorized Official

Name: DR. ARTHUR J KOHN
Title or Position: OWNER
Credential: MD
Phone: 847-410-2029