Healthcare Provider Details

I. General information

NPI: 1760557987
Provider Name (Legal Business Name): MICHELLE YVONNE KARNEY MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/22/2006
Last Update Date: 02/01/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

31 N VIRGINIA ST
CRYSTAL LAKE IL
60014-4125
US

IV. Provider business mailing address

31 N VIRGINIA ST
CRYSTAL LAKE IL
60014-4125
US

V. Phone/Fax

Practice location:
  • Phone: 815-585-3002
  • Fax:
Mailing address:
  • Phone: 815-585-3002
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VB0002X
TaxonomyObesity Medicine (Obstetrics & Gynecology) Physician
License Number036108293
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: