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General NPI Number Information
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NPI Number | 1013948470
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Entity Type | Individual
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Provider Name | KEVIN C CARNEY X M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/05/2006
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Last Update Date | 09/27/2024
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Provider Practice Location Address
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Address Line | 6400 SHAFER CT STE 600
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City | ROSEMONT
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State | IL
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Zip | 60018-4988
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Country | US
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Telephone | 847-983-8257
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Fax |
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Provider Business Mailing Address
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Address Line | 5835 W WILSON AVE
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City | CHICAGO
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State | IL
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Zip | 60630-3323
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Country | US
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Telephone | 773-706-3821
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Fax | 773-685-3734
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 036080283
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License Number State | IL
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