Provider Demographics
NPI:1013106947
Name:KIRK M. CONTENTO DPM PC
Entity Type:Organization
Organization Name:KIRK M. CONTENTO DPM PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KIRK
Authorized Official - Middle Name:M
Authorized Official - Last Name:CONTENTO
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:708-361-6118
Mailing Address - Street 1:11801 SOUTHWEST HWY
Mailing Address - Street 2:2-N
Mailing Address - City:PALOS HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60463-1037
Mailing Address - Country:US
Mailing Address - Phone:708-361-6118
Mailing Address - Fax:708-361-6042
Practice Address - Street 1:11801 SOUTHWEST HWY
Practice Address - Street 2:2-N
Practice Address - City:PALOS HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60463-1037
Practice Address - Country:US
Practice Address - Phone:708-361-6118
Practice Address - Fax:708-361-6042
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-16
Last Update Date:2007-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILU08999Medicare UPIN
IL208117Medicare PIN