Provider Demographics
NPI:1750371340
Name:CARNEY, MICHELE C (MD)
Entity type:Individual
Prefix:
First Name:MICHELE
Middle Name:C
Last Name:CARNEY
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 1:300 RANDALL RD
Mailing Address - Street 2:
Mailing Address - City:GENEVA
Mailing Address - State:IL
Mailing Address - Zip Code:60134-4200
Mailing Address - Country:US
Mailing Address - Phone:630-653-4240
Mailing Address - Fax:630-938-9190
Practice Address - Street 1:608 S WASHINGTON ST STE 204
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60540-6675
Practice Address - Country:US
Practice Address - Phone:630-348-3080
Practice Address - Fax:630-646-5648
Is Sole Proprietor?:No
Enumeration Date:2005-10-25
Last Update Date:2024-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036103394207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036103394 1Medicaid
H68577Medicare UPIN
ILL93023Medicare PIN
IL036103394 1Medicaid
IL160058502Medicare PIN
IL160058503Medicare PIN
ILL93022Medicare PIN