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FENNER PLASTIC SURGERY, LTD.
NPI 1316194285
Plastic Surgery in Kenilworth, IL

Active since August 22, 2008CLIA 14D2025451 · Waiver
512 GREEN BAY RD, KENILWORTH, IL 60043(847) 716-2400(847) 716-2401 Get Directions Write a Review

NPPES record last updated: October 29, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Fenner Plastic Surgery, Ltd. NPPES

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

FENNER PLASTIC SURGERY, LTD. (NPI 1316194285) is a healthcare organization registered as a plastic surgery in Kenilworth, Illinois and active in the NPI registry since August 2008. The organization holds a CLIA Waiver certificate valid through June 8, 2027 and lists Geoffrey Craig Fenner, Physician/owner, as its authorized official.

NPPES Registry Identity

NPI1316194285
Entity TypeOrganization
Primary Taxonomy208200000X
Legal Business NameFENNER PLASTIC SURGERY, LTD.
Location Address512 GREEN BAY RDKenilworth, IL 60043-1073
Mailing Address512 Green Bay RdKenilworth, IL 60043-1073 · (847) 716-2400 · Fax (847) 716-2401
Phone(847) 716-2400
Fax(847) 716-2401
Organization SubpartNo
Authorized OfficialGeoffrey Craig FennerPhysician/owner · (847) 716-2400
Enumeration DateAugust 22, 2008
Last NPPES UpdateOctober 29, 2020
NPPES CertifiedOctober 29, 2020
✔ NPI 1316194285 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPlastic SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code208200000X
License✔ Licensed in IL · 036081864
Definition
A plastic surgeon deals with the repair, reconstruction or replacement of physical defects of form or function involving the skin, musculoskeletal system, craniomaxillofacial structures, hand, extremities, breast and trunk and external genitalia or cosmetic enhancement of these areas of the body. Cosmetic surgery is an essential component of plastic surgery. The plastic surgeon uses cosmetic surgical principles to both improve overall appearance and to optimize the outcome of reconstructive procedures. The surgeon uses aesthetic surgical principles not only to improve undesirable qualities of normal structures but in all reconstructive procedures as well.
512 GREEN BAY RD, Kenilworth, IL 60043
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 14D2025451

Fenner Plastic Surgery · Kenilworth, IL
Active · expires Jun 8, 2027
CLIA Number14D2025451
Laboratory TypeBlood Bank
Certificate Effective DateJune 9, 2025
Certificate Expiration DateJune 8, 2027
Laboratory DirectorGeoffrey Fenner MD
Laboratory Phone(847) 716-2400
Laboratory LocationFenner Plastic Surgery512 Green Bay Rd, Kenilworth, IL 60043
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 2

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

KENILWORTH SURGERY LLC
Clinic/Center (Ambulatory Surgical)
512 GREEN BAY RD
KENILWORTH, IL 60043
Cook County (847) 716-2400
CLAIRE SOCH PA
Physician Assistant
512 GREEN BAY RD
KENILWORTH, IL 60043
Cook County (847) 716-2400

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 Fenner Plastic Surgery, Ltd.'s NPI number?

The NPI number for Fenner Plastic Surgery, Ltd. is 1316194285. It was assigned to this organization in the NPPES registry on August 22, 2008.

Where is Fenner Plastic Surgery, Ltd. located?

Fenner Plastic Surgery, Ltd. is located at 512 Green Bay Rd, Kenilworth, IL 60043. The listed phone number is (847) 716-2400.

What is Fenner Plastic Surgery, Ltd.'s specialty?

The primary specialty registered for this NPI is Plastic Surgery with taxonomy code 208200000X.

Does Fenner Plastic Surgery, Ltd. hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 14D2025451) is associated with this NPI, valid through June 8, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Fenner Plastic Surgery, Ltd. was last updated on October 29, 2020. 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.