| Claire Kenneally, Ltd | |
|
530 Winnetka Ave Winnetka IL 60093-4023 | |
| (847) 441-6868 | |
| (847) 441-6895 |
| Full Name | Claire Kenneally, Ltd |
|---|---|
| Speciality | Internal Medicine |
| Location | 530 Winnetka Ave, Winnetka, Illinois |
| Authorized Official Name and Position | Claire Kenneally (PHYSICIAN) |
| Authorized Official Contact | 8474416868 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Claire Kenneally, Ltd 530 Winnetka Ave Winnetka IL 60093-4023 Ph: (847) 441-6868 | Claire Kenneally, Ltd 530 Winnetka Ave Winnetka IL 60093-4023 Ph: (847) 441-6868 |
| NPI Number | 1720272685 |
|---|---|
| Provider Enumeration Date | 09/04/2007 |
| Last Update Date | 08/01/2024 |
| Certification Date | 08/01/2024 |
| Medicare PECOS PAC ID | 5799871455 |
|---|---|
| Medicare Enrollment ID | O20071011000361 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720272685 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 036118323 (Illinois) | Primary |
| Provider Name | Claire E Kenneally |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1952521981 PECOS PAC ID: 6305931262 Enrollment ID: I20071008000062 |
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