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General NPI Number Information
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NPI Number | 1700802501
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Entity Type | Individual
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Provider Name | LAURIE KENFIELD MD
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Gender | Female
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Dates
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Enumeration Date | 07/14/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 3231 EUCLID AVE SUITE 404
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City | BERWYN
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State | IL
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Zip | 60402-3471
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Country | US
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Telephone | 708-442-9839
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Fax |
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Provider Business Mailing Address
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Address Line | 3231 EUCLID AVE STE 404
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City | BERWYN
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State | IL
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Zip | 60402-3472
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Country | US
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Telephone | 708-749-9060
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Fax | 708-749-0429
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State | IL
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