Most Relevant Information
Provider Data
| NPI Number: | 1003047267 |
| Provider Name: | RAELENE D KENNEDY MD |
| Entity Type: | Individual |
| Taxonomy Code: | 2086S0102X |
| Specialty: | Surgery |
| License Number: | 036-148573 |
Most Important Dates
| Enumeration Date: | 08/05/2009 |
| Last Updated: | 08/30/2019 |
Provider Practice Location
1725 W HARRISON ST STE 810
CHICAGO
IL
60612
Practice Location Phone/Fax
| Phone: | 3129425500 |
| Fax: |
Provider Mailing Location
1725 W HARRISON ST STE 810
CHICAGO
IL
606123863
Provider Mailing Phone/Fax
| Phone: | 3129425500 |
| Fax: |