Healthcare Provider Details

I. General information

NPI: 1699028001
Provider Name (Legal Business Name): KENNETH MICHAEL WELCH MB,CH.B, FRCP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/23/2012
Last Update Date: 12/08/2025
Certification Date: 12/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

802 W BARTLETT RD
BARTLETT IL
60103-4400
US

IV. Provider business mailing address

802 W BARTLETT RD
BARTLETT IL
60103-4400
US

V. Phone/Fax

Practice location:
  • Phone: 603-858-6998
  • Fax:
Mailing address:
  • Phone: 603-858-6998
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084B0002X
TaxonomyObesity Medicine (Psychiatry & Neurology) Physician
License Number036.112075
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code2084V0102X
TaxonomyVascular Neurology Physician
License Number036.112075
License Number StateIL
# 3
Primary TaxonomyN
Taxonomy Code2084P2900X
TaxonomyPain Medicine (Psychiatry & Neurology) Physician
License Number036.112075
License Number StateIL
# 4
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number036.112075
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: