Organization Active NPI

Vein Specialists of Geneva LTD.

  • Emergency Medicine Physician
  • Geneva, IL
National Provider Identifier
1255029567
Registry record updated Jun 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
Legal business name
VEIN SPECIALISTS OF GENEVA LTD.
Practice address
1792 S Randall Rd
Geneva, IL 60134-4602
Phone
(630) 425-0800
Fax
(630) 425-0799
NPI assigned
Apr 25, 2023
Last updated
Jun 7, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2023

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

Authorized official

Name
Kevin Kern, DONPI 1144258781
Title
Owner
Phone
(630) 425-0800

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X NU Primary

Addresses

Primary practice location

1792 S Randall Rd
Geneva, IL 60134-4602

Mailing address

1792 S Randall Rd
Geneva, IL 60134-4602
Phone (630) 425-0800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230601000832 IL Part B Supplier - Clinic/Group Practice 6002273323 Receives reassigned benefits from 1 practitioner
Practice locations: Geneva, IL

National Provider Directory

National Provider Directory

Locations

713 Meacham Rd
Elk Grove Village, IL 60007

1792 S Randall Rd
Geneva, IL 60134
Phone (630) 425-0800

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1682380800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1686096000000",
    "number": "1255029567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1792 S RANDALL RD",
            "city": "GENEVA",
            "state": "IL",
            "postal_code": "601344602",
            "telephone_number": "630-425-0800",
            "fax_number": "630-425-0799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1792 S RANDALL RD",
            "city": "GENEVA",
            "state": "IL",
            "postal_code": "601344602",
            "telephone_number": "630-425-0800",
            "fax_number": "630-425-0799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VEIN SPECIALISTS OF GENEVA LTD.",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-04-25",
        "last_updated": "2023-06-07",
        "certification_date": "2023-06-07",
        "status": "A",
        "authorized_official_last_name": "KERN",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "630-425-0800",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Geneva, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.