Organization
KENILWORTH SURGERY LLC
Active
Other names
Fenner Ambulatory Surgical Center
Organization subpart
No
Provider details
NPI number
Authorized official
GEOFFREY C FENNER MD (PHYSICIAN/OWNER)
(847) 716-2400
Entity
Organization
Contact information
Practice address
512 GREEN BAY RD, KENILWORTH, IL 60043-1073
(847) 716-2400
(847) 716-2441
Mailing address
512 GREEN BAY RD, KENILWORTH, IL 60043-1073
(847) 716-2400
(847) 716-2441
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Enumeration date
10/29/2015
Last updated
07/21/2022
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