Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080N0001X | Neonatal-Perinatal Doctor | 036102134 | IL |
N | 2080N0001X | Neonatal-Perinatal Doctor | MD456419 | PA |
NPI | 1013036151 |
---|---|
Provider Name | Dr. Ama Koranteng |
First Address | Willowbrook, IL 60527-5418 |
Second Address | Willowbrook, IL 60527-5418 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/03/2007 |
Last Update Date | 24/06/2019 |