Provider Demographics
NPI:1598897878
Name:WELCH, KEVIN C (MD)
Entity Type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:C
Last Name:WELCH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:2160 S 1ST AVE
Mailing Address - Street 2:MAGUIRE BLDG
Mailing Address - City:MAYWOOD
Mailing Address - State:IL
Mailing Address - Zip Code:60153-3328
Mailing Address - Country:US
Mailing Address - Phone:708-216-9183
Mailing Address - Fax:708-216-4834
Practice Address - Street 1:2160 S 1ST AVE
Practice Address - Street 2:MAGUIRE BLDG
Practice Address - City:MAYWOOD
Practice Address - State:IL
Practice Address - Zip Code:60153-3328
Practice Address - Country:US
Practice Address - Phone:708-216-9183
Practice Address - Fax:708-216-4834
Is Sole Proprietor?:No
Enumeration Date:2007-03-12
Last Update Date:2011-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036.121164207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology