Individual
KENNETH MICHAEL KWIATKOWSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1250 N MILL ST, SUITE 100, NAPERVILLE, IL 60563-6304
(630) 355-6996
(630) 355-0026
Mailing address
1250 N MILL ST STE 100, LOWER LEVEL, NAPERVILLE, IL 60563-6305
(630) 355-6996
(630) 355-0026
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
036070989
IL
208000000X
Pediatrics Physician
5101009035
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036070989
—
IL
01
—
2223081
BLUE CROSS
IL
Enumeration date
08/08/2006
Last updated
03/07/2023
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