Kenneth J Liesen in St Charles - Family Medicine
Kenneth J Liesen - NPI 1699896498
Kenneth J Liesen is a Family Medicine in St Charles, Illinois. Kenneth J Liesen practices all healthcare services and medical treatments related to Family Medicine. The NPI Number for Kenneth J Liesen is 1699896498. The last update date is 2014-04-23.
Kenneth J Liesen's current location address is 606 Riverside Ave, St Charles, Illinois. You can contact this provider via phone number 6305848900. The mailing address for Kenneth J Liesen is 606 Riverside Ave, St Charles, Illinois. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Kenneth J Liesen |
|---|---|
| Address | 606 Riverside Ave, St Charles, Illinois |
| Phone Number | 6305848900 |
| Fax Number | |
| Sole Proprietor | Y |
| Credentials | M.D. |
NPI Number Detail
| NPI Number | 1699896498 |
|---|---|
| Provider Enumeration Date | 2007-04-02 |
| Last Updated Date | 2014-04-23 |
Provider Mailing Address Detail
| Address | 606 Riverside Ave |
|---|---|
| City | St Charles |
| State | Illinois (IL) |
| Post Code | 601742969 |
| Phone Number | 6305848900 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Family Medicine |
|---|---|
| Taxonomy | 207Q00000X |
| Licence No | 036-077277 |
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Definition: Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine i |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 36077277 | IL | -- | |
| 966700 | IL | PTAN | |
| 36077277 | IL | UNITED HEALTH | |
| 36077277 | IL | BLUE CROSS |
Post Comment/ Review Below
What is the unique identifier code issued to Kenneth J Liesen by the Centers for Medicare & Medicaid Services?
The Kenneth J Liesen has been assigned the NPI (National Provider Identifier) 1699896498. This 10-digit code serves as a unique identification number for healthcare providers issued by the Centers for Medicare & Medicaid Services (CMS).
Can you provide the Kenneth J Liesen's physical address?
The Kenneth J Liesen is physically located at 606 Riverside Ave, in the city of St Charles, IL, with the postal code 601742969.
What is the area of specialization for Kenneth J Liesen, and what is the corresponding taxonomy classification code for this field?
The specialized field of practice for Kenneth J Liesen is Family Medicine, and the corresponding taxonomy code that categorizes this area of expertise is 207Q00000X.
On what date did the Centers for Medicare & Medicaid Services issue the 1699896498 to Kenneth J Liesen?
The Kenneth J Liesen received its 1699896498 assignment from the Centers for Medicare & Medicaid Services on 2007-04-02.
When was the information related to Kenneth J Liesen most recently updated or refreshed?
The details pertaining to the Kenneth J Liesen, including its address, specialty, and other relevant information, were last updated or refreshed on 2014-04-23.
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