Organization
PRADEEP A KENI M D S C
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SANJAY P KENI M.D. (DOCTOR)
(708) 371-3090
Entity
Organization
Contact information
Practice address
6420 W 127TH ST STE 106, PALOS HEIGHTS, IL 60463-2297
(708) 371-3090
(708) 371-1529
Mailing address
6420 W 127TH ST STE 106, PALOS HEIGHTS, IL 60463-2297
(708) 371-3090
(708) 371-1529
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
0360-46184
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
21604442
BLUE SHIELD
IL
Enumeration date
09/01/2006
Last updated
07/18/2025
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