Individual
DR. KEVIN TODD HARRIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1525 OXFORD LN, NAPERVILLE, IL 60565-1511
(630) 983-0300
(630) 983-9360
Mailing address
401 N MICHIGAN AVE, SUITE 1200, CHICAGO, IL 60611-4264
(312) 635-0973
(813) 290-9691
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
036.128435
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
036128435
LICENSE NO
IL
05
—
036128435
—
IL
01
—
P01116374
RR MEDICARE
IL
Enumeration date
08/14/2007
Last updated
10/29/2015
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