MEDICARE: CONOR KINFORD MD

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
1	208600000X	Surgery Physician	036165771	IL
2	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1841827862
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CONOR KINFORD MD

Provider Business Mailing Address
First Line	:	2650 RIDGE AVE STE 1223
Second Line	:
City	:	EVANSTON
State	:	IL
Zip	:	60201-1700
Country	:	US
Telephone Number	:	847-570-2040
Fax Number	:	847-570-5315

Provider Business Practice Location Address
First Line	:	5140 N CALIFORNIA AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60625-3645
Country	:	US
Telephone Number	:	773-293-5331
Fax Number	:	773-907-3540

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/27/2020
Last Update Date	:	05/19/2026

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Directions to “ CONOR KINFORD MD” Practice Location

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