Healthcare Provider Details

I. General information

NPI: 1649609231
Provider Name (Legal Business Name): JENNIFER L KENAR MS, CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/05/2013
Last Update Date: 07/03/2025
Certification Date: 07/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3249 OAK PARK AVE
BERWYN IL
60402-3429
US

IV. Provider business mailing address

1235 S PRAIRIE AVE UNIT 905
CHICAGO IL
60605-3403
US

V. Phone/Fax

Practice location:
  • Phone: 708-783-3006
  • Fax:
Mailing address:
  • Phone: 773-865-7687
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number041.356819
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number209-011110
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: