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General NPI Number Information
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NPI Number | 1699089656
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Entity Type | Individual
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Provider Name | ALEXANDER V KENDALL PA-C
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Gender | Male
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Dates
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Enumeration Date | 08/02/2010
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Last Update Date | 08/02/2010
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Provider Practice Location Address
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Address Line | 1925 E RAND RD
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City | ARLINGTON HEIGHTS
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State | IL
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Zip | 60004-4366
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Country | US
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Telephone | 847-253-3300
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Fax |
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Provider Business Mailing Address
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Address Line | 1606 HINMAN AVE #3R
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City | EVANSTON
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State | IL
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Zip | 60201-6034
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Country | US
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Telephone | 617-913-3771
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Fax |
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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 | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 085003804
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License Number State | IL
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