Individual
KENNETH VERCELLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1020 E OGDEN AVE, STE 115, NAPERVILLE, IL 60563-8609
(630) 717-8707
Mailing address
1860 PAYSPHERE CIR, CHICAGO, IL 60674-0018
(630) 469-9200
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
036082561
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036082561
—
IL
Enumeration date
03/27/2006
Last updated
05/06/2015
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