Healthcare Provider Details

I. General information

NPI: 1750202974
Provider Name (Legal Business Name): KENNY ASPUREZ RN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/23/2026
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1653 W CONGRESS PKWY APT 1
CHICAGO IL
60612-3833
US

IV. Provider business mailing address

1812 RIDGELAND AVE APT 1
BERWYN IL
60402-2027
US

V. Phone/Fax

Practice location:
  • Phone: 312-947-0100
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number041.502523
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: