Rebecca J Kennedy, MD

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

Practice address

755 S Milwaukee Ave
#181
Libertyville, IL 60048

Phone

(847) 816-1228

Fax

(847) 816-1262

NPI assigned

Aug 30, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

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

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Ear, Nose & Throat Specialists of Illinois LTD

  • Specialist
  • Park Ridge, IL
  • NPI 1750340949
  Medicare reassignment NPD
• Midwest ENT Alliance PLLC

  • Otolaryngology Physician
  • Orland Park, IL
  • NPI 1588449458
  NPD (past)

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1669582581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "755 S MILWAUKEE AVE",
            "address_2": "#181",
            "city": "LIBERTYVILLE",
            "state": "IL",
            "postal_code": "60048",
            "telephone_number": "847-816-1228",
            "fax_number": "847-816-1262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "755 S MILWAUKEE AVE",
            "address_2": "#181",
            "city": "LIBERTYVILLE",
            "state": "IL",
            "postal_code": "60048",
            "telephone_number": "847-816-1228",
            "fax_number": "847-816-1262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNEDY",
        "first_name": "REBECCA",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Allison Keenan
• Brian Robert Kelchen, D.C.
• Jordan Lee Kellgren, M.S. CCC-SLP
• Kelly Behrends, PSYD, PC
• Jauren D Kelly, PSY.D.
• Malan Hasula Kern, MD
• Kimberly L Kesner, M.D.
• Eric Jonathan Kessler, M.D.
• Maria S. Khan, M.D.
• Najla Khan, MD

• Otolaryngology Physician in Libertyville, IL
• Providers in Libertyville, IL by specialty
• Otolaryngology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.