Provider Demographics
NPI:1154368942
Name:KENNETH S. TOTH, M.D.,S.C.
Entity type:Organization
Organization Name:KENNETH S. TOTH, M.D.,S.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:S
Authorized Official - Last Name:TOTH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:847-381-9600
Mailing Address - Street 1:450 W HIGHWAY 22
Mailing Address - Street 2:
Mailing Address - City:BARRINGTON
Mailing Address - State:IL
Mailing Address - Zip Code:60010-7509
Mailing Address - Country:US
Mailing Address - Phone:847-381-9600
Mailing Address - Fax:
Practice Address - Street 1:8135 N MILWAUKEE AVE
Practice Address - Street 2:
Practice Address - City:NILES
Practice Address - State:IL
Practice Address - Zip Code:60714-2828
Practice Address - Country:US
Practice Address - Phone:847-967-1149
Practice Address - Fax:847-967-8594
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-01
Last Update Date:2007-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL04932242OtherBLUE SHIELD OF ILLINOIS
IL04932242OtherBLUE SHIELD OF ILLINOIS
H94100Medicare UPIN