Individual
KELLY MARIE FENING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
315 W CARPENTER ST, SPRINGFIELD, IL 62702-4901
(217) 545-8000
(217) 545-7762
Mailing address
PO BOX 19638, SPRINGFIELD, IL 62794-9638
(217) 545-8000
(217) 545-7762
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
1295364974
PA
208C00000X
Colon & Rectal Surgery Physician
Primary
036.176495
IL
208C00000X
Colon & Rectal Surgery Physician
Primary
OT020006
PA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/05/2020
Last updated
07/30/2026
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