Healthcare Provider Details

I. General information

NPI: 1194808667
Provider Name (Legal Business Name): ARTHRITIS & INTERNAL MEDICINE SPECIALIST
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/20/2006
Last Update Date: 01/18/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9701 KNOX AVE STE 102
SKOKIE IL
60076-1256
US

IV. Provider business mailing address

9701 N. KNOX AVE STE 102
SKOKIE IL
60076
US

V. Phone/Fax

Practice location:
  • Phone: 847-674-7520
  • Fax: 847-674-3358
Mailing address:
  • Phone: 847-674-7520
  • Fax: 847-674-3358

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code305R00000X
TaxonomyPreferred Provider Organization
License Number
License Number StateIL

VIII. Authorized Official

Name: DR. SCOTT ALLEN KALE
Title or Position: PRESIDENT
Credential: M.D
Phone: 847-674-7520