=====================================================
General NPI Number Information
=====================================================
NPI Number | 1013106947
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | KIRK M. CONTENTO DPM PC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/16/2007
-----------------------------------------------------
Last Update Date | 10/16/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 11801 SOUTHWEST HWY 2-N
-----------------------------------------------------
City | PALOS HEIGHTS
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 60463-1037
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 708-361-6118
-----------------------------------------------------
Fax | 708-361-6042
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 11801 SOUTHWEST HWY 2-N
-----------------------------------------------------
City | PALOS HEIGHTS
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 60463-1037
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 708-361-6118
-----------------------------------------------------
Fax | 708-361-6042
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER/PRESIDENT
-----------------------------------------------------
Name | DR. KIRK M. CONTENTO
-----------------------------------------------------
Credential | DPM
-----------------------------------------------------
Telephone | 708-361-6118
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 213E00000X
-----------------------------------------------------
Taxonomy Name | Podiatrist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State | IL
-----------------------------------------------------