MEDICARE: DR. ADAM S KENNEDY

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	222Q00000X	Developmental Therapist		IL

General Provider Information

NPI Number	:	1851714547
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ADAM S KENNEDY

Provider Business Mailing Address
First Line	:	820 N MICHIGAN AVE
Second Line	:	SUITE 1100
City	:	CHICAGO
State	:	IL
Zip	:	60611-2147
Country	:	US
Telephone Number	:	312-915-6857
Fax Number	:

Provider Business Practice Location Address
First Line	:	820 N MICHIGAN AVE
Second Line	:	SUITE 1100
City	:	CHICAGO
State	:	IL
Zip	:	60611-2147
Country	:	US
Telephone Number	:	312-915-6857
Fax Number	:

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

Provider Enumeration Date	:	01/30/2014
Last Update Date	:	01/30/2014

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Directions to “ DR. ADAM S KENNEDY ” Practice Location

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