Individual
MARY GRACE KENNY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
836 W WELLINGTON AVE, CHICAGO, IL 60657-5147
(708) 304-9700
(773) 296-3020
Mailing address
470 FAIRVIEW AVE, GLEN ELLYN, IL 60137-5346
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
125.082595
IL
Other
Enumeration date
03/30/2023
Last updated
08/04/2024
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