Kenneth J Liesen Md Sc in St Charles - Family Medicine
Kenneth J Liesen Md Sc - NPI 1124223763
Kenneth J Liesen Md Sc is a Family Medicine in St Charles, Illinois. Kenneth J Liesen Md Sc practices all healthcare services and medical treatments related to Family Medicine. The NPI Number for Kenneth J Liesen Md Sc is 1124223763. The last update date is 2014-01-17.
Kenneth J Liesen Md Sc's current location address is 606 Riverside Ave, St Charles, Illinois. You can contact this provider via phone number 6305848900 and fax number 6305842806. The mailing address for Kenneth J Liesen Md Sc is 606 Riverside Ave, St Charles, Illinois. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Kenneth J Liesen Md Sc |
|---|---|
| Address | 606 Riverside Ave, St Charles, Illinois |
| Phone Number | 6305848900 |
| Fax Number | 6305842806 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | MEDICAL DO |
|---|---|
| Authorized Official Name | Liesen J Kenneth |
| Credentials | MD |
| Telephone Number | 6305848900 |
NPI Number Detail
| NPI Number | 1124223763 |
|---|---|
| Provider Enumeration Date | 2007-06-15 |
| Last Updated Date | 2014-01-17 |
Provider Mailing Address Detail
| Address | 606 Riverside Ave |
|---|---|
| City | St Charles |
| State | Illinois (IL) |
| Post Code | 601742969 |
| Phone Number | 6305848900 |
| Fax Number | 6305842806 |
Provider's Primary Taxonomy Detail
| Speciality | Family Medicine |
|---|---|
| Taxonomy | 207Q00000X |
| Licence No | 36077277 |
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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 | INDIVIDUAL MEDICARE PTAN | |
| 36077277 | IL | BCBS | |
| 943790 | IL | GROUP PTAN |
Post Comment/ Review Below
What is the unique 10-digit identifier code issued to Kenneth J Liesen Md Sc by the Centers for Medicare & Medicaid Services?
The Kenneth J Liesen Md Sc has been assigned the NPI (National Provider Identifier) 1124223763 by the CMS (Centers for Medicare & Medicaid Services). This 10-digit code serves as a unique identification number for healthcare providers.
Could you kindly provide the complete physical address where Kenneth J Liesen Md Sc's facilities are geographically located?
The facilities of Kenneth J Liesen Md Sc are physically situated at the following location: 606 Riverside Ave, St Charles, IL, 601742969.
What is Kenneth J Liesen Md Sc's specialized field of practice, and what is the corresponding taxonomy code that categorizes this area of expertise?
The area of specialization for Kenneth J Liesen Md Sc is Family Medicine, and the taxonomy code that classifies this field of practice is 207Q00000X.
On what date did the Centers for Medicare & Medicaid Services assign the 1124223763 to Kenneth J Liesen Md Sc?
The Centers for Medicare & Medicaid Services assigned the 1124223763 to Kenneth J Liesen Md Sc on 2007-06-15.
When was the information pertaining to Kenneth J Liesen Md Sc most recently updated or revised?
The details related to Kenneth J Liesen Md Sc, including its address, specialty, and other relevant information, were last updated or revised on 2014-01-17.