Michael George Kennedy O.D.

NPI 1417111790 - Optometrist - 152W00000X

NPI Details
NPI 1417111790
Gender Male
Enumeration Date 07/15/2008
Last Updated 09/10/2012
Entity Type Individual
Active Over 8 years ago
Practice Location
363 S RANDALL RD
ELGIN IL, 60123-5526, US
Phone (847) 888-1555
Fax
Business Location
363 S RANDALL RD
ELGIN IL, 60123-5526, US
Phone (847) 888-1555
Fax
Toxanomy
Taxonomy Code 152W00000X
License State Illinois
License Number 046010127
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According to our database, Dr. Michael George Kennedy O.D. NPI is 1417111790, taxonomy code is 152W00000X and license number is 046010127, license state is located at Illinois. Michael George Kennedy O.D. physically located at 363 S Randall Rd, Elgin IL, 60123-5526. NPI Number Michael George Kennedy O.D. has the Individual type.

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1417111790 NPI number is provided on an as is basis without warranty of any kind. 1417111790 is maintained by the National Plan & Provider Enumeration System. The contents of Michael George Kennedy O.D. are for informational purposes only.