Alexandrea Kennedy
Individual provider Active NPI Athletic Trainer · Channahon, IL
NPI 1124562285 · NPPES record last updated Dec 8, 2016
Key facts
- NPI
- 1124562285
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Athletic Trainer 2255A2300X
- Practice address
- 26145 W Sylvan Meadow Dr
Channahon, IL 60410-3447 - Phone
- (815) 514-9386
- NPI assigned
- Dec 8, 2016
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | Yes |
Addresses
Primary practice location
26145 W Sylvan Meadow Dr
Channahon, IL 60410-3447
Mailing address
26145 W Sylvan Meadow Dr
Channahon, IL 60410-3447
Other providers in Channahon, IL
- Dustin Joder
- Louis B Kaducak
- Adam Kagan
- Kapable Kids, Inc.
- Michelle Keeton
- Cynthia Rae Kiper
- Taylor Krull
- Amanda Layne
- Brenda Leisinger
- Sheree Beth Lettman
All providers in Channahon, IL · Athletic Trainer in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 8, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.