DR. KENNETH ARCEDRICK MUNNERLYN MD NPI 1316172513

NPI Information

NPI: 1316172513
Provider Name: DR. KENNETH ARCEDRICK MUNNERLYN, MD
Classification: Psychiatry & Neurology - 2084N0400X
Entity Type: Individual

Specialization: Neurology

PECOS Registration: Yes

Address:
800 W CENTRAL RD
ARLINGTON HEIGHTS, IL
ZIP 60005
Phone: (847) 618-5671
Get Directions

DR. Kenneth Arcedrick Munnerlyn, MD is a neurology psychiatry neurology in Arlington Heights, IL with 15 years of experience. The provider is a Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures. DR. Kenneth Arcedrick Munnerlyn, MD NPI is 1316172513. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

800 W CENTRAL RD
ARLINGTON HEIGHTS, IL
ZIP 60005-349
Phone: (847) 618-5671
Fax: (847) 618-5669

The NPI 1316172513 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 5/18/2009 and was last updated on 11/9/2021.

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	2084N0400X	Psychiatry & Neurology	Neurology	01076175A	INDIANA	No
2	2084N0400X	Psychiatry & Neurology	Neurology	036133586	ILLINOIS	No
3	2084N0400X	Psychiatry & Neurology	Neurology	056609	CONNECTICUT	Yes
4	2084N0400X	Psychiatry & Neurology	Neurology	80701	GEORGIA	No

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	1316172513	MEDICAID	WISCONSIN

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: 4/28/2024

NPI Synchronization or Removal

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