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NPI Code Detail

MEDICARE: AMY KISSINGER M.D.

MEDICARE: AMY KISSINGER M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine Physician036097861IL

General Provider Information

NPI Number : 1548215841
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMY KISSINGER M.D.
Provider Business Mailing Address
First Line : 676 N SAINT CLAIR ST STE 415
Second Line :
City : CHICAGO
State : IL
Zip : 60611-3133
Country : US
Telephone Number : 312-926-3627
Fax Number : 312-694-4102
Provider Business Practice Location Address
First Line : 676 N SAINT CLAIR ST STE 415
Second Line :
City : CHICAGO
State : IL
Zip : 60611-3133
Country : US
Telephone Number : 312-926-3627
Fax Number : 312-694-4102
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/24/2006
Last Update Date : 10/29/2019

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Directions to “ AMY KISSINGER M.D.” Practice Location

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