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Individual

KEVIN PATRICK KERN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
1792 S RANDALL RD, GENEVA, IL 60134-4602
(630) 425-0800
(630) 425-0799
Mailing address
1792 S RANDALL RD, GENEVA, IL 60134-4602
(630) 425-0800
(630) 425-0799

Taxonomy

Speciality
Code
Description
License number
State
202K00000X
Phlebology Physician
Primary
036101395
IL
207P00000X
Emergency Medicine Physician
036101395
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
789511
GROUP MEDICARE PTAN
IL
01
79510
GROUP MEDICARE PTAN
IL
Enumeration date
06/30/2006
Last updated
01/24/2024
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