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General NPI Number Information
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NPI Number | 1255029567
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Entity Type | Organization
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Legal Business Name | VEIN SPECIALISTS OF GENEVA LTD.
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Dates
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Enumeration Date | 04/25/2023
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Last Update Date | 06/07/2023
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Provider Practice Location Address
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Address Line | 1792 S RANDALL RD
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City | GENEVA
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State | IL
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Zip | 60134-4602
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Country | US
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Telephone | 630-425-0800
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Fax | 630-425-0799
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Provider Business Mailing Address
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Address Line | 1792 S RANDALL RD
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City | GENEVA
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State | IL
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Zip | 60134-4602
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Country | US
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Telephone | 630-425-0800
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Fax | 630-425-0799
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Authorized Official
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Title or Position | OWNER
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Name | KEVIN KERN
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Credential | DO
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Telephone | 630-425-0800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number |
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License Number State |
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