Individual
MR. WARREN K KENNEDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
3420 ILLINOIS ST, GREAT LAKES, IL 60088-3120
(847) 688-2522
Mailing address
3420 ILLINOIS STREET, GREAT LAKES, ID 60088-1312
(847) 688-2522
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
—
—
Other
Enumeration date
12/24/2007
Last updated
12/24/2007
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