Paul M Kentor MD SC

Primary specialty

Allergy & Immunology PhysicianTaxonomy code 207K00000X

License

036044332 Issued in IL

Legal business name

PAUL M KENTOR MD SC

Practice address

580 Roger Williams Ave Ste 25
Highland Park, IL 60035-4820

Phone

(847) 634-1690

Fax

(847) 634-1841

NPI assigned

Apr 4, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Paul M Kentor, MDNPI 1538146758

Title

Physician

Phone

(847) 634-1690

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Locations

Practitioners 1

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

• Paul M Kentor, MD

  • Allergy Physician
  • Highland Park, IL
  • NPI 1538146758
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1175644800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1697155200000",
    "number": "1275655151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "580 ROGER WILLIAMS AVE STE 25",
            "city": "HIGHLAND PARK",
            "state": "IL",
            "postal_code": "600354820",
            "telephone_number": "847-634-1690",
            "fax_number": "847-634-1841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "580 ROGER WILLIAMS AVE STE 25",
            "city": "HIGHLAND PARK",
            "state": "IL",
            "postal_code": "600354820",
            "telephone_number": "847-634-1690",
            "fax_number": "847-634-1841"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1215 McHenry Rd",
            "address_2": "Suite 130B",
            "address_purpose": "LOCATION",
            "city": "Buffalo Grove",
            "state": "IL",
            "postal_code": "600891370",
            "country_code": "US",
            "telephone_number": "847-634-1690",
            "fax_number": "847-634-1841",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PAUL M KENTOR MD SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-04",
        "last_updated": "2023-10-13",
        "certification_date": "2023-10-13",
        "status": "A",
        "authorized_official_last_name": "KENTOR",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "847-634-1690",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Allergy & Immunology",
            "state": "IL",
            "license": "036044332",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MCR IND PTAN",
            "identifier": "K12415",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MCR PTAN",
            "identifier": "DG7085",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MCR GROUP PTAN",
            "identifier": "IL8708",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP",
            "identifier": "210357",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Priya Sheth Patel, PA-C
• Shalini N Patel, MD
• Sunil Patel
• Vairagi Patel, O.D.
• Pathfinder Health
• Noah Payant, DPT
• Whitney Payne
• Peaceful Mind Therapy, PLLC
• Katharine Pearson, MA, CCC-SLP/L
• Angela Marie Pecora, PA-C

• Allergy & Immunology Physician in Highland Park, IL
• Providers in Highland Park, IL by specialty
• Allergy & Immunology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 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.