Kelly Marie Fening, DO is a medicare enrolled "Colon & Rectal Surgery" physician in Park Ridge, Illinois. Her current practice location is
1775 Dempster St, Mailbox #48, Park Ridge, Illinois. You can reach out to her office (for appointments etc.) via phone at
(847) 723-2210.
Kelly Marie Fening is licensed to practice in Pennsylvania (license number OT020006) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1295364974.
Physician's Profile
Full Name | Kelly Marie Fening |
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Gender | Female |
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Speciality | Colon & Rectal Surgery |
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Location | 1775 Dempster St, Mailbox #48, Park Ridge, Illinois |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1295364974
- Provider Enumeration Date: 04/05/2020
- Last Update Date: 04/11/2025
Medicare PECOS Information:
- PECOS PAC ID: 4385013523
- Enrollment ID: I20221212000792
Medical Identifiers
Medical identifiers for Kelly Marie Fening such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1295364974 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
208C00000X | Colon & Rectal Surgery | OT020006 (Pennsylvania) | Primary |
208600000X | Surgery | 1295364974 (Pennsylvania) | Secondary |
390200000X | Student In An Organized Health Care Education/training Program | (* (Not Available)) | Secondary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Kelly Marie Fening is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Kelly Marie Fening, DO 4300 Londonderry Rd, Harrisburg, PA 17109-5317 Ph: (717) 657-7484 | Kelly Marie Fening, DO 1775 Dempster St, Mailbox #48, Park Ridge, IL 60068 Ph: (847) 723-2210 |
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