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Kenneth Craig Micetich, MD
Hematology & Oncology Physician in Maywood, Illinois
NPI 1619954583

Kenneth Craig Micetich is a Hematology & Oncology Physician based in Maywood, IL and is specialized in Hematology & Oncology. Kenneth Craig Micetich practices in Maywood, IL and has the professional credentials of MD. The NPI Number for Kenneth Craig Micetich is 1619954583 and holds a License No. 36056032 (Illinois).

The current practice location address for Kenneth Craig Micetich is 2160 S 1St Ave, Maywood, IL and can be reached out via phone at 708-645-3400 and via fax at 708-645-3411.

Location: 2160 S 1St Ave, Maywood, IL, 60153-3328
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1619954583
Provider Name
Kenneth Craig Micetich
Credential
MD
Provider Entity Type
Individual
Gender
Male
Address
2160 S 1St Ave, Maywood, IL, 60153-3328
Phone Number
708-645-3400
Fax Number
708-645-3411
Provider Enumeration Date
12/30/2005
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
36056032 05 IL
institution
Provider Business Practice Location Address Details
Address
2160 S 1St Ave
City
Maywood
State
Illinois
Zip
60153-3328
Phone Number
708-645-3400
Fax Number
708-645-3411
person
Provider Business Mailing Address Details
Address
2160 S 1St Ave
City
Maywood
State
Illinois
Zip
60153-3328
Phone Number
708-645-3400
Fax Number
708-645-3411
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
Internal Medicine
Speciality
Hematology & Oncology
Taxonomy
207RH0003X
License No.
36056032 (Illinois)
Definition
An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered.
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