Kenneth J Nelson, M.D.

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

036065299 Issued in IL

Practice address

4905 Old Orchard Ctr Ste 200
Skokie, IL 60077-1462

Phone

(847) 869-5800

Fax

(847) 869-9315

NPI assigned

Aug 22, 2005

Last updated

Jan 23, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/21117/brand/1/csg/1/fhir/r4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Midwest Center for Women's Healthcare

  • Obstetrics & Gynecology Physician
  • Evanston, IL
  • NPI 1477673085
  NPD (past)
• Midwest Center for Women's Healthcare

  • Obstetrics & Gynecology Physician
  • Evanston, IL
  • NPI 1689971665
  NPD (past)

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

{
    "created_epoch": "1124668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579737600000",
    "number": "1649262023",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2801 LAKESIDE DR STE 209",
            "city": "BANNOCKBURN",
            "state": "IL",
            "postal_code": "600151271",
            "telephone_number": "847-562-1410",
            "fax_number": "847-562-0830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4905 OLD ORCHARD CTR STE 200",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600771462",
            "telephone_number": "847-869-5800",
            "fax_number": "847-869-9315"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "KENNETH",
        "middle_name": "J",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-22",
        "last_updated": "2020-01-23",
        "certification_date": "2020-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "IL",
            "license": "036065299",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Peter J Navarro, LPC
• Desiree Neal
• Melissa Vitt Negoita, LCSW
• Neil R Friedman MD LTD
• Julia Nellamattom, PA-C
• Tia-Monique F Nelson, MSN, FP-APRN, FNP-C
• Laura Nemoy
• Steven Harry Neren, PHD
• Neuro-Psych Technologies, LTD.
• New Day Therapy

• Obstetrics & Gynecology Physician in Skokie, IL
• Providers in Skokie, IL by specialty
• Obstetrics & Gynecology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 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.