MEDICARE: DR. PEGGY LYNN KENDALL MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	2020002762	MO
2	207RA0201X	Allergy & Immunology (Internal Medicine) Physician	2020002762	MO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1306938725
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PEGGY LYNN KENDALL MD

Provider Business Mailing Address
First Line	:	PO BOX 7412011
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60674-2011
Country	:	US
Telephone Number	:	314-996-8670
Fax Number	:	866-362-4984

Provider Business Practice Location Address
First Line	:	425 S EUCLID AVE
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63110-1005
Country	:	US
Telephone Number	:	314-996-8670
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/30/2006
Last Update Date	:	02/17/2026

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