Individual provider Active NPI

Laurie Kenfield, MD

  • Psychiatry Physician
  • Berwyn, IL
National Provider Identifier
1700802501
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Practice address
3231 Euclid Ave
Suite 404
Berwyn, IL 60402-3471
Phone
(708) 442-9839
NPI assigned
Jul 14, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X IL Primary

Addresses

Primary practice location

3231 Euclid Ave
Suite 404
Berwyn, IL 60402-3471

Mailing address

3231 Euclid Ave Ste 404
Berwyn, IL 60402-3472
Phone (708) 749-9060

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20040428001351 IL Practitioner - Psychiatry 4385631613 Practice locations: Chicago, IL; Riverside, IL

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 1986
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

25 E Washington
Suite 2036
Chicago, IL 60602-1818
Phone (708) 749-9060

84 E Burlington St
1E
Riverside, IL 60546-2119
Phone (708) 749-9060

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036-079100ILMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Presence Behavioral Health Past Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1152835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1700802501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3231 EUCLID AVE STE 404",
            "city": "BERWYN",
            "state": "IL",
            "postal_code": "604023472",
            "telephone_number": "708-749-9060",
            "fax_number": "708-749-0429"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3231 EUCLID AVE",
            "address_2": "SUITE 404",
            "city": "BERWYN",
            "state": "IL",
            "postal_code": "604023471",
            "telephone_number": "708-442-9839"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENFIELD",
        "first_name": "LAURIE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Berwyn, IL

Sources for this page

Verify at the official NPI Registry.