Organization Active NPI

Kennedy Medical Service Corp

  • Obstetrics & Gynecology Physician
  • Chicago, IL
National Provider Identifier
1003975442
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
Legal business name
KENNEDY MEDICAL SERVICE CORP
Practice address
175 E Delaware PL
Suite 5024
Chicago, IL 60611-1756
Phone
(312) 504-0438
NPI assigned
Dec 8, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Lofton Kennedy Jr., M.D.
Title
Ceo
Phone
(312) 504-0438

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207V00000X Primary

Addresses

Primary practice location

175 E Delaware PL
Suite 5024
Chicago, IL 60611-1756

Mailing address

175 E Delaware PL
Suite 5024
Chicago, IL 60611-1756
Phone (312) 504-0438

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1165536000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1003975442",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "175 E DELAWARE PL",
            "address_2": "SUITE 5024",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606111756",
            "telephone_number": "312-504-0438"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 E DELAWARE PL",
            "address_2": "SUITE 5024",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606111756",
            "telephone_number": "312-504-0438"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENNEDY MEDICAL SERVICE CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-08",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KENNEDY",
        "authorized_official_first_name": "LOFTON",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "312-504-0438",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.