Geoffrey C Fenner (NPI# 1629176003, PAC ID# 9739111337) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is PLASTIC AND RECONSTRUCTIVE SURGERY.
| Nation Provider ID (NPI) | 1629176003 |
| PAC ID by PECOS | 9739111337 |
| Professional Enrollment ID | I20050902000668 |
| Full Name | Geoffrey C Fenner |
| Address |
512 Green Bay Rd Kenilworth IL 60043-1073 |
| Gender | M |
| Credential | MD |
| Medical School | INDIANA UNIVERSITY SCHOOL OF MEDICINE |
| Graduation Year | 1988 |
| Primary Specialty | PLASTIC AND RECONSTRUCTIVE SURGERY |
| Secondary Specialties | GENERAL SURGERY |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 140010 | NORTHSHORE UNIVERSITY HEALTHSYSTEM - EVANSTON HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 512 Green Bay Rd, Kenilworth, IL 60043-1073 |
| Street Address |
512 GREEN BAY RD |
| City | KENILWORTH |
| State | IL |
| Zip | 60043-1073 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Rebecca E Lucas | Physical Therapy | Accelerated Rehabilitation Centers Ltd | 554 Green Bay Rd, Kenilworth, IL 60043-1086 |
| Katharine M Albright | Physical Therapy | Accelerated Rehabilitation Centers Ltd | 554 Green Bay Rd, Kenilworth, IL 60043-1086 |
| Edward Refundo | Physical Therapy | Accelerated Rehabilitation Centers Ltd | 554 Green Bay Rd, Kenilworth, IL 60043-1086 |
| Kathleen Chrysta Piazzi | Occupational Therapy | Accelerated Rehabilitation Centers Ltd | 554 Green Bay Rd, Kenilworth, IL 60043-1086 |
| Joby John | Physical Therapy | Accelerated Rehabilitation Centers Ltd | 554 Green Bay Rd, Kenilworth, IL 60043-1086 |
| Julie Manner | Physical Therapy | Accelerated Rehabilitation Centers Ltd | 554 Green Bay Rd, Kenilworth, IL 60043-1086 |
| Caitlin A Murray | Physical Therapy | Accelerated Rehabilitation Centers Ltd | 554 Green Bay Rd, Kenilworth, IL 60043-1086 |
| Brad E Powell | Physical Therapy | Accelerated Rehabilitation Centers Ltd | 554 Green Bay Rd, Kenilworth, IL 60043-1086 |
| Dylan F Mohler | Physical Therapy | Accelerated Rehabilitation Centers Ltd | 554 Green Bay Rd, Kenilworth, IL 60043-1086 |
| Cathleen J Robinson | Occupational Therapy | Accelerated Rehabilitation Centers Ltd | 554 Green Bay Rd, Kenilworth, IL 60043-1086 |
| Find all physicians in zip 60043 | |||
| City | KENILWORTH |
| Zip Code | 60043 |
| Specialty | PLASTIC AND RECONSTRUCTIVE SURGERY |
| City + Specialty | KENILWORTH + PLASTIC AND RECONSTRUCTIVE SURGERY |
Please comment or provide details below to improve the information on Geoffrey C Fenner.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.