Individual
DR. KENNETH ALAN MICHELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
225 E CHICAGO AVE, CHICAGO, IL 60611-2991
(312) 227-4000
Mailing address
225 E CHICAGO AVE, CHICAGO, IL 60611-2991
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
250030
MA
2080P0204X
Pediatric Emergency Medicine (Pediatrics) Physician
Primary
250030
MA
Other
Enumeration date
06/08/2009
Last updated
06/13/2023
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