Individual
GEOFFREY C FENNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
512 GREEN BAY ROAD, KENILWORTH, IL 60043
(847) 716-2400
(847) 716-2401
Mailing address
512 GREEN BAY ROAD, KENILWORTH, IL 60043
(847) 716-2400
(847) 716-2401
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
036081864
IL
Other
Enumeration date
09/20/2006
Last updated
10/29/2020
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