Vicencio, Kenneth
Vicencio, Kenneth is an individual health care provider with primary practice located at 10730 W 143Rd St Ste 37 , Orland Park IL 60462-1940. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical Neuropsychologist, which is considered as his primary health care specialty. Vicencio, Kenneth can be contacted via phone (800) 564-0863.Contact Information
Primary practice address
10730 W 143Rd St Ste 37
Orland Park IL 60462-1940
Phone: (800) 564-0863
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical Neuropsychologist | 103G00000X | ||
| Behavioral Health & Social Service Providers / Clinical Neuropsychologist | 103G00000X | 071009682 | Illinois |
Profile Details
| NPI number | 1891211710 |
|---|---|
| LBN Legal business name | Vicencio, Kenneth |
| Credentials | PSYD |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 22nd, 2017 |
| Last updated | Sep 27th, 2022 - about 4 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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