Provider Demographics
NPI:1760557987
Name:KARNEY, MICHELLE YVONNE (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:YVONNE
Last Name:KARNEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31 N VIRGINIA ST
Mailing Address - Street 2:
Mailing Address - City:CRYSTAL LAKE
Mailing Address - State:IL
Mailing Address - Zip Code:60014-4125
Mailing Address - Country:US
Mailing Address - Phone:815-585-3002
Mailing Address - Fax:
Practice Address - Street 1:31 N VIRGINIA ST
Practice Address - Street 2:
Practice Address - City:CRYSTAL LAKE
Practice Address - State:IL
Practice Address - Zip Code:60014-4125
Practice Address - Country:US
Practice Address - Phone:815-585-3002
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-22
Last Update Date:2017-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036108293207VB0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VB0002XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObesity Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
H87052Medicare UPIN
IL214660 L99367Medicare ID - Type Unspecified
IL036108293 1Medicaid