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General NPI Number Information
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NPI Number | 1235231366
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Entity Type | Organization
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Legal Business Name | PRADEEP A KENI M D S C
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Dates
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Enumeration Date | 09/01/2006
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Last Update Date | 07/18/2025
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Provider Practice Location Address
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Address Line | 6420 W 127TH ST STE 106
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City | PALOS HEIGHTS
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State | IL
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Zip | 60463-2297
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Country | US
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Telephone | 708-371-3090
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Fax | 708-371-1529
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Provider Business Mailing Address
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Address Line | 6420 W 127TH ST STE 106
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City | PALOS HEIGHTS
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State | IL
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Zip | 60463-2297
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Country | US
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Telephone | 708-371-3090
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Fax | 708-371-1529
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Authorized Official
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Title or Position | DOCTOR
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Name | DR. SANJAY P KENI
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Credential | M.D.
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Telephone | 708-371-3090
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 0360-46184
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License Number State | IL
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