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NPI Code Detail

MEDICARE: DR. JOSEPH KENYON ASBURY M.D.

MEDICARE: DR. JOSEPH KENYON ASBURY M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine Physician114324IL
2207RG0300XGeriatric Medicine (Internal Medicine) Physician036114324IL

General Provider Information

NPI Number : 1730114612
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JOSEPH KENYON ASBURY M.D.
Provider Business Mailing Address
First Line : 1229 N NORTH BRANCH ST
Second Line : SUITE 206
City : CHICAGO
State : IL
Zip : 60642-2473
Country : US
Telephone Number : 312-030-5090
Fax Number : 312-640-4496
Provider Business Practice Location Address
First Line : 1229 N NORTH BRANCH ST
Second Line : SUITE 206
City : CHICAGO
State : IL
Zip : 60642-2473
Country : US
Telephone Number : 312-939-5090
Fax Number : 312-640-4496
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/11/2006
Last Update Date : 11/06/2009

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