Provider Demographics
NPI:1518459759
Name:KANTAR MEDICAL CONSULTANTS SC
Entity Type:Organization
Organization Name:KANTAR MEDICAL CONSULTANTS SC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MOUHANNAD
Authorized Official - Middle Name:
Authorized Official - Last Name:KANTAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:702-308-6892
Mailing Address - Street 1:1051 ESSINGTON RD STE 290
Mailing Address - Street 2:
Mailing Address - City:JOLIET
Mailing Address - State:IL
Mailing Address - Zip Code:60435-2842
Mailing Address - Country:US
Mailing Address - Phone:815-773-7827
Mailing Address - Fax:815-254-8442
Practice Address - Street 1:1051 ESSINGTON RD STE 290
Practice Address - Street 2:
Practice Address - City:JOLIET
Practice Address - State:IL
Practice Address - Zip Code:60435-2842
Practice Address - Country:US
Practice Address - Phone:815-773-7827
Practice Address - Fax:815-254-8442
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-04
Last Update Date:2022-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric MedicineGroup - Multi-Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontologyGroup - Multi-Specialty