Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
GEOFFREY C FENNER, MD
Active Sole ProprietorGEOFFREY C FENNER, MD is a Plastic Surgery healthcare provider located in KENILWORTH, Illinois. NPI 1629176003 is currently active in the NPPES registry. Verify at CMS.
Plastic Surgery · KENILWORTH, IL
Registration Details
- NPI Number
- 1629176003
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Sep 20, 2006 (19.914900419607 yrs)
- Last Updated
- Oct 29, 2020
- License
-
036081864 (IL)
- Sole Proprietor
- Yes
Practice Information
- Address
-
512 GREEN BAY ROADKENILWORTH, IL, 60043Browse IL providers · Browse ZIP 60043
- Phone
- 8477162400
- Fax
- 8477162401
- Primary Specialty
-
Plastic Surgery
208200000X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.