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Contact Information

GEOFFREY C FENNER, MD
512 GREEN BAY ROAD
KENILWORTH, IL60043
 Phone: 847-716-2400
 Fax: 847-716-2401
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Plastic Surgery

208200000X 02 Physician/General Surgery
Indicates primary specialty

NPI Profile & details for GEOFFREY C FENNER · (Male)

NPI # 1629176003
Status Active
Credentials MD
Entity Individual
Enumeration date 09/20/2006
Last updated 10/29/2020 - About 6 years ago
Sole proprietor 1 Yes
Identifiers
  • IL License # 036081864
Hospital affiliation(s)
  • EVANSTON HOSPITAL - (Acute Care)
    2650 RIDGE AVE
    EVANSTON, IL 60201
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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