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Dr. Charles Anthony Amenta III, MD
Specialist in Homewood, Illinois
NPI 1467444620

Charles Anthony Amenta III is a Specialist based in Homewood, IL. Charles Anthony Amenta III practices in Homewood, IL and has the professional credentials of MD. The NPI Number for Charles Anthony Amenta III is 1467444620 and holds a License No. 036075600 (Illinois).

The current practice location address for Charles Anthony Amenta III is 18161 Morris Ave, Homewood, IL and can be reached out via phone at 708-799-5520 and via fax at 708-799-5358.

Location: 18161 Morris Ave, Homewood, IL, 60430-2108
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1467444620
Provider Name
Charles Anthony Amenta III
Credential
MD
Provider Entity Type
Individual
Gender
Male
Address
18161 Morris Ave, Homewood, IL, 60430-2108
Phone Number
708-799-5520
Fax Number
708-799-5358
Provider Enumeration Date
08/15/2005
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
036075600 05 IL
040010012 01 GA RAILROAD MEDICARE
05055067 01 TX AETNA
01606798 01 IL BLUE CROSS BLUE SHIELD
institution
Provider Business Practice Location Address Details
Address
18161 Morris Ave
City
Homewood
State
Illinois
Zip
60430-2108
Phone Number
708-799-5520
Fax Number
708-799-5358
person
Provider Business Mailing Address Details
Address
18161 Morris Ave
City
Homewood
State
Illinois
Zip
60430-2108
Phone Number
708-799-5520
Fax Number
708-799-5358
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Specialist
Speciality
-
Taxonomy
174400000X
License No.
036075600 (Illinois)
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
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