Individual
DR. PRADEEP A KENI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
6420 W 127TH ST STE 106, PALOS HEIGHTS, IL 60463-2297
(708) 371-3090
(708) 371-1529
Mailing address
6420 W 127TH ST STE 106, PALOS HEIGHTS, IL 60463-2297
(708) 371-3090
(708) 371-1529
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
036046184
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036046184
—
IL
01
—
21604442
BLUE SHIELD
IL
Enumeration date
09/13/2007
Last updated
07/18/2025
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