Kenneth Micetich, MD

NPI 1619954583 · on the registry since 2005

Practice

Address: 2160 S 1st Ave
(15750 Marion Dr., Homer Glen, Il. 60491)
Maywood, IL 60153
Phone: (708) 645-3400
Fax: (708) 645-3411
Organisation at this address: Walgreen Co
Walgreen Co
Rosin Optical Co., Inc.
Proviso Partners For Health
Loyola University Health System
Inferred from a shared address, not stated in the registry.
Clinicians at this address: 2,186

Registry record

Primary taxonomy: 207RH0003X
207RH0003X
Licence states on file: IL
From the registry's licence fields, which are often incomplete.
Sex: Male
Record last updated: 2010-01-06

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Illinois