Provider Demographics
NPI:1518117233
Name:NAVE, KENNETH SESLEY (MD)
Entity Type:Individual
Prefix:DR
First Name:KENNETH
Middle Name:SESLEY
Last Name:NAVE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:KENNETH
Other - Middle Name:S
Other - Last Name:NAVE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:8539 S SAGINAW AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60617-2444
Mailing Address - Country:US
Mailing Address - Phone:773-768-9893
Mailing Address - Fax:
Practice Address - Street 1:8836 S ASHLAND AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60620-4956
Practice Address - Country:US
Practice Address - Phone:773-629-6036
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-30
Last Update Date:2012-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-100667207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine