PRADEEP A KENI M D S C NPI 1235231366

NPI Information

NPI: 1235231366
Provider Name: PRADEEP A KENI M D S C
Classification: Specialist - 174400000X
Entity Type: Organization
Address:
6420 W 127TH ST STE 106
PALOS HEIGHTS, IL
ZIP 60463
Phone: (708) 371-3090
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PRADEEP A KENI M D S C is a specialist in Palos Heights, IL. The provider is 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. PRADEEP A KENI M D S C NPI is 1235231366. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

6420 W 127TH ST STE 106
PALOS HEIGHTS, IL
ZIP 60463-297
Phone: (708) 371-3090
Fax: (708) 371-1529

The provider's authorized official is Pradeep A Keni .
The authorized official title is Doctor and has the following contact phone number (708) 371-3090.

The enumeration date for this NPI number is 9/1/2006 and was last updated on 7/16/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	174400000X	Specialist		0360-46184	ILLINOIS	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	21604442	OTHER	ILLINOIS	BLUE SHIELD
2	036046184	MEDICAID	ILLINOIS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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