DR. MICHAEL GEORGE KENNEDY (NPI# 1417111790) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417111790 |
| Entity Type | Individual |
| Full Name | DR. MICHAEL GEORGE KENNEDY |
| Credential | O.D. |
| Practice Address |
363 S Randall Rd Elgin IL 60123-5526 |
| Practice Telephone | 8478881555 |
| Mailing Telephone | 8478881555 |
| Enumeration Date | 2008-07-15 |
| Last Update Date | 2012-09-10 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 152W00000X | Optometrist | 046010127 | IL | Eye and Vision Services Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | OTHER NPI | 1891842464 | 01 |
| IL | TAX ID | 36-3546473 | 01 |
| IL | GROUP NPI FOR BCBS | 1508088683 | 01 |
| IL | BCBS | 4515286 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992047427 | Michael W Kennedy | General Practice | 6686 Eagle Crossing Blvd, Brownsburg, IN 46112-7420 | 2013-03-22 |
| 1861732760 | Michael Kennedy | Social Worker | 865 Memorial Pkwy, Phillipsburg, NJ 08865-2730 | 2013-03-01 |
| 1306116066 | Michael Shawn Kennedy | Psychologist | 113 Hawk Dr, Dulce, NM 87528 | 2012-01-11 |
| 1558507749 | Michael Patrick Kennedy | Registered Nurse | 11310 Huron St Ste 100, Northglenn, CO 80234-3090 | 2008-12-18 |
| 1861678435 | Michael George Kennedy | Social Worker | 1290 W 8th Pl, Suite A, Yuma, AZ 85364-3621 | 2008-01-14 |
| 1992985550 | Michael Arthur Kennedy | Preventive Medicine | 62 N. Chapel St, #100, Physicians Group, LLC, Newark, DE 19711-2238 | 2007-11-11 |
| 1639358088 | Michael John Kennedy | Chiropractor | 12105 41st Ave N, Apt 118, Plymouth, MN 55441-1200 | 2007-11-01 |
| 1588879043 | Michael Thomas Kennedy | Surgery | 28144 El Montanero, Laguna Niguel, CA 92677-7545 | 2007-05-10 |
| 1245361815 | Michael C Kennedy | Chiropractor | 3580 Rte 281, Cortland, NY 13045 | 2007-03-08 |
| 1245391473 | Michael Arthur Kennedy | Physician Assistant | 111 E Hwy 120, Ste. 104, Pottsboro, TX 75076-3008 | 2006-12-12 |
| Street Address |
363 S RANDALL RD |
| City | ELGIN |
| State | IL |
| Zip Code | 60123-5526 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508088683 | Susan M Penner | Optometrist | 363 S Randall Rd, Elgin, IL 60123 | 2007-05-02 |
| 1992996383 | Ellen Renee Petroczky | Optometrist | 363 S Randall Rd, Elgin Family Eye Care, Elgin, IL 60123-5526 | 2007-08-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629625736 | Edna Lopez | Social Worker | 1140 N. Mclean Blvd #1, Elgin, IL 60123 | 2019-08-22 |
| 1003472259 | Katelyn Lee O'connell | Counselor | 695 S. Sate Street, Elgin, IL 60123 | 2019-05-14 |
| 1598235152 | Katie Elizabeth Dwyer | Counselor | 695 S. State Street, Elgin, IL 60123 | 2018-11-27 |
| 1174002778 | James M Accetta | Counselor | 52 Surry Drive, Elgin, IL 60123 | 2018-08-14 |
| 1770086175 | Griswold Home Care | Adult Companion | 707 A Davis Road, Suite 203, Elgin, IL 60123 | 2018-03-12 |
| 1003315706 | Danielle Bryant | Nurse Practitioner | 745 Fletcher Dr Ste 101, Elgin, IL 60123 | 2018-02-08 |
| 1912421470 | Deborah Foshager | Counselor | 680 Shenandoah Trail, Elgin, IL 60123 | 2017-07-26 |
| 1760903470 | Miguel Camargo | Specialist/Technologist | 12 N Aldine St, Elgin, IL 60123 | 2017-07-03 |
| 1134658594 | David Sommer | Counselor | 1460 Umbdenstock Rd, Elgin, IL 60123 | 2017-06-08 |
| 1649719618 | Faheem Unisa Syed | Clinical Nurse Specialist | 1990 Larkin Ave., Elgin, IL 60123 | 2017-02-23 |
| Find all providers in zip 60123 | ||||
| Taxonomy Code | 152W00000X |
| Grouping | Eye and Vision Services Providers |
| Classification | Optometrist |
| Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system. |
| Notes: Source: American Optometric Association (AOA), approved by the AOA’s Board of Trustees, June 21, 2005. [7/1/2006: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093295305 | Clayton William Rutkowski | Optometrist | 1205 Hwy 290 E, Elgin, TX 78621-2018 | 2018-08-16 |
| 1114470267 | Michelle Hanh Ma | Optometrist | 1205 Highway 290 W, Elgin, TX 78621 | 2016-07-25 |
| 1467826057 | Elgin Vision Pllc | Optometrist | 1205 W. Highway 290, Elgin, TX 78621 | 2015-11-19 |
| 1477986826 | Yasham Sharaf Alam | Optometrist | 502 Waverly Dr, Elgin, IL 60120-4082 | 2013-08-20 |
| 1710137757 | Morfoot Eyecare | Optometrist | 815 S Randall Rd, Elgin, IL 60123-3003 | 2008-09-26 |
| 1598942427 | Manal Hajali | Optometrist | 502 Waverly Drive, Elgin, IL 60120 | 2008-01-22 |
| 1508088683 | Susan M Penner | Optometrist | 363 S Randall Rd, Elgin, IL 60123 | 2007-05-02 |
| 1609924745 | Toshio Nakajima | Optometrist | 165 S Randall Rd, Elgin, IL 60123 | 2007-01-08 |
| 1013012327 | Family Vision Clinic LLP | Optometrist | 110 Main St N, Elgin, ND 58533 | 2006-09-13 |
| 1649386608 | Maria Jean Nelsen | Optometrist | 1001 N Randall Rd, Elgin, IL 60123-2319 | 2006-08-22 |
| Find all providers in ELGIN | ||||
Please comment or provide details below to improve the information on DR. MICHAEL GEORGE KENNEDY.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.