Provider Demographics
NPI:1649266933
Name:KENT, JOSEPH H (MD)
Entity type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:H
Last Name:KENT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:901 MCCLINTOCK DR
Mailing Address - Street 2:SUITE 202
Mailing Address - City:BURR RIDGE
Mailing Address - State:IL
Mailing Address - Zip Code:60527-0872
Mailing Address - Country:US
Mailing Address - Phone:888-220-6432
Mailing Address - Fax:630-654-4253
Practice Address - Street 1:13755 S. CICERO AVE
Practice Address - Street 2:
Practice Address - City:CRESTWOOD
Practice Address - State:IL
Practice Address - Zip Code:60445
Practice Address - Country:US
Practice Address - Phone:888-220-6432
Practice Address - Fax:708-385-7840
Is Sole Proprietor?:No
Enumeration Date:2005-09-22
Last Update Date:2021-12-21
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IL036-071273207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036-071-273Medicaid
IA0420315Medicaid
IL036-071-273Medicaid
ILD13418Medicare UPIN
ILL82072Medicare PIN
ILL72391Medicare PIN
ILL72392Medicare PIN
IAI10610006Medicare PIN