Charles Kinney Jr.

Primary specialty

Chore ProviderTaxonomy code 372500000X

Practice address

112 W Park St Apt 1E
Elwood, IL 60421-9628

Phone

(815) 540-2875

NPI assigned

Mar 18, 2025

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1742256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742256000000",
    "number": "1568262525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 DAVISON ST APT 2",
            "city": "JOLIET",
            "state": "IL",
            "postal_code": "604331369",
            "telephone_number": "815-540-2875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 W PARK ST APT 1E",
            "city": "ELWOOD",
            "state": "IL",
            "postal_code": "604219628",
            "telephone_number": "815-540-2875"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KINNEY",
        "first_name": "CHARLES",
        "name_suffix": "Jr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-03-18",
        "last_updated": "2025-03-18",
        "certification_date": "2025-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251V00000X",
            "taxonomy_group": "",
            "desc": "Voluntary or Charitable",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "IL",
            "license": null,
            "primary": false
        },
        {
            "code": "372500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chore Provider",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tyler Donald Demers, PSY.D, LP
• Brittany Dragmeier, LPC
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• Michael David Geraci, LCSW
• Autumn Marie Lawson
• Donna Lee Lyle, RN
• Keilene McCants
• McNierney Podiatry, P.C.
• William Francis McNierney Jr., DPM

• Chore Provider in Elwood, IL
• Providers in Elwood, IL by specialty
• Chore Provider in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2025; 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.