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General NPI Number Information
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NPI Number | 1003011966
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Entity Type | Individual
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Provider Name | AARON DANIEL KALLSNICK M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/19/2007
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Last Update Date | 07/15/2022
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Provider Practice Location Address
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Address Line | 5645 W ADDISON ST
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City | CHICAGO
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State | IL
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Zip | 60634-4403
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Country | US
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Telephone | 773-282-7000
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Fax |
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Provider Business Mailing Address
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Address Line | 1301 W 22ND ST #610
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City | OAK BROOK
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State | IL
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Zip | 60523-2006
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Country | US
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Telephone | 630-537-1720
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 036.127038
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 64206
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License Number State | WI
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