Individual provider Active NPI

Kenneth Paul Jesunas, M.D.

  • Otolaryngology Physician
  • Joliet, IL
National Provider Identifier
1790723799
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
36 041709 Issued in IL
Practice address
3077 W Jefferson St
Suite 206
Joliet, IL 60435-5262
Phone
(815) 744-2500
Fax
(815) 744-3550
NPI assigned
Jun 2, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X 36 041709 IL Primary

Addresses

Primary practice location

3077 W Jefferson St
Suite 206
Joliet, IL 60435-5262

Mailing address

3077 W Jefferson St
Suite 206
Joliet, IL 60435-5262
Phone (815) 744-2500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
36 041709ILMDOtolaryngology Physician

NPI Registry JSON

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

{
    "created_epoch": "1149206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1790723799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3077 W JEFFERSON ST",
            "address_2": "SUITE 206",
            "city": "JOLIET",
            "state": "IL",
            "postal_code": "604355262",
            "telephone_number": "815-744-2500",
            "fax_number": "815-744-3550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3077 W JEFFERSON ST",
            "address_2": "SUITE 206",
            "city": "JOLIET",
            "state": "IL",
            "postal_code": "604355262",
            "telephone_number": "815-744-2500",
            "fax_number": "815-744-3550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JESUNAS",
        "first_name": "KENNETH",
        "middle_name": "PAUL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-02",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "IL",
            "license": "36 041709",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Joliet, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.