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DR. KENNETH J KAVANAUGH DO
NPI 1104819697
Family Medicine in Sandwich, IL

Active since August 30, 2005
1 E COUNTYLINE RD, SANDWICH, IL 60548(815) 786-2722(815) 786-6840 Get Directions Write a Review

NPPES record last updated: March 2, 2021. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Mar 2, 2021, Feb 24, 2021, Feb 10, 2021 (3 updates tracked since 2021).

About Dr. Kenneth J Kavanaugh Do NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. KENNETH J KAVANAUGH DO (NPI 1104819697) is an individual family medicine provider in Sandwich, Illinois, licensed in Illinois (036077591) and active in the NPI registry since August 2005.

NPPES Registry Identity

NPI1104819697
Entity TypeIndividualMale
Primary Taxonomy207Q00000X
Provider Legal NameDR. KENNETH J KAVANAUGHCredential: DO
Location Address1 E COUNTYLINE RDSandwich, IL 60548-2178
Mailing Address1 E Countyline RdSandwich, IL 60548-2178 · (815) 786-2722 · Fax (815) 786-6840
Phone(815) 786-2722
Fax(815) 786-6840
Sole ProprietorNo
Enumeration DateAugust 30, 2005
Last NPPES UpdateMarch 2, 20213 updates tracked since enumeration
NPPES CertifiedMarch 2, 2021
✔ NPI 1104819697 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in IL · 036077591
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
1 E COUNTYLINE RD, Sandwich, IL 60548
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Other Identifiers 2

Other1921614IL · Bc/bs
Medicaid036077591IL

Other Providers at the Same Location NPPES 14

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. RICHARD W MASON DO
Surgery
1 E COUNTYLINE RD
SANDWICH, IL 60548
Dekalb County (815) 786-2722
EDWARD HEALTH VENTURES
Family Medicine
1 E COUNTYLINE RD
SANDWICH, IL 60548
Dekalb County (815) 786-2722
DR. MARK DONALD WEINHOLD D.D.S.
Dentist (General Practice)
1 E COUNTYLINE RD, SUITE A
SANDWICH, IL 60548
Dekalb County (815) 786-2185
DR. MARIA DANA SUTKUS DO
Family Medicine
1 E COUNTYLINE RD
SANDWICH, IL 60548
Dekalb County (815) 786-2722
PRAIRIE HEALTHCARE, LTD
Family Medicine
1 E COUNTYLINE RD
SANDWICH, IL 60548
Dekalb County (815) 786-2722
REZIN ORTHOPEDIC AND SPORTS MEDICINE, SC
Durable Medical Equipment & Medical Supplies
1 E COUNTYLINE RD
SANDWICH, IL 60548
Dekalb County (815) 786-1517
DR. ERIC J JANOTA DO
Family Medicine
1 E COUNTYLINE RD
SANDWICH, IL 60548
Dekalb County (815) 786-2722
DR. DANIEL D GAUTHIER DO
Family Medicine
1 E COUNTYLINE RD
SANDWICH, IL 60548
Dekalb County (815) 786-2722

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kenneth Kavanaugh's NPI number?

The NPI number for Kenneth Kavanaugh is 1104819697. It was assigned to this individual provider in the NPPES registry on August 30, 2005.

Where is Kenneth Kavanaugh located?

Kenneth Kavanaugh practices at 1 E Countyline Rd, Sandwich, IL 60548. The listed phone number is (815) 786-2722.

What is Kenneth Kavanaugh's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

When was this NPI record last updated?

The NPPES record for Kenneth Kavanaugh was last updated on March 2, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.