Provider Demographics
NPI:1275919375
Name:KISS, MARC-OLIVIER (MD)
Entity Type:Individual
Prefix:MR
First Name:MARC-OLIVIER
Middle Name:
Last Name:KISS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4646 N. MARINE DRIVE
Mailing Address - Street 2:BONE AND JOINT REPLACEMENT CENTER
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60640
Mailing Address - Country:US
Mailing Address - Phone:773-564-5881
Mailing Address - Fax:773-564-5886
Practice Address - Street 1:4646 N. MARINE DRIVE
Practice Address - Street 2:BONE AND JOINT REPLACEMENT CENTER
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60640
Practice Address - Country:US
Practice Address - Phone:773-564-5881
Practice Address - Fax:773-564-5886
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-31
Last Update Date:2016-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program