KENNETH CRAIG MICETICH

MAYWOOD, IL
NPI1619954583
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy207RH0003X Internal Medicine, Hematology & Oncology
(Licence: IL  36056032)
Enumeration Date2005-12-30
Last Update Date2010-01-06
Business Address
-- KENNETH CRAIG MICETICH MD
2160 S 1ST AVE (15750 MARION DR., HOMER GLEN, IL. 60491)
MAYWOOD, IL 60153-3328
Phone number: 708-645-3400
Mailing Address
-- KENNETH CRAIG MICETICH MD
2160 S 1ST AVE (15750 MARION DR., HOMER GLEN, IL. 60491)
MAYWOOD, IL 60153-3328
Phone number: 708-645-3400
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