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KENNETH VICENCIO PSYD
NPI 1891211710
Clinical Neuropsychologist in Orland Park, IL

Active since August 22, 2017
10730 W 143RD ST STE 37, ORLAND PARK, IL 60462(800) 564-0863 Get Directions Write a Review

NPPES record last updated: September 27, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Sep 27, 2022, Nov 18, 2021, Jul 9, 2021 and 3 more (6 updates tracked since 2017).

About Kenneth Vicencio Psyd NPPES

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

KENNETH VICENCIO PSYD (NPI 1891211710) is an individual clinical neuropsychologist in Orland Park, Illinois, licensed in Illinois (071009682) and active in the NPI registry since August 2017. He maintains a secondary practice location in Buffalo Grove.

NPPES Registry Identity

NPI1891211710
Entity TypeIndividualMale
Primary Taxonomy103G00000X
Provider Legal NameKENNETH VICENCIOCredential: PSYD
Location Address10730 W 143RD ST STE 37Orland Park, IL 60462-1940
Mailing Address10730 W 143rd St Ste 37Orland Park, IL 60462-1940 · (800) 564-0863
Phone(800) 564-0863
Sole ProprietorNo
Enumeration DateAugust 22, 2017
Last NPPES UpdateSeptember 27, 20226 updates tracked since enumeration
NPPES CertifiedSeptember 27, 2022
✔ NPI 1891211710 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinical NeuropsychologistBehavioral Health & Social Service Providers
Taxonomy Code103G00000X
License✔ Licensed in IL · 071009682
Definition
A clinical psychologist who applies principles of assessment and intervention based upon the scientific study of human behavior as it relates to normal and abnormal functioning of the central nervous system. The specialty is dedicated to enhancing the understanding of brain-behavior relationships and the application of such knowledge to human problems.
10730 W 143RD ST STE 37, Orland Park, IL 60462
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Secondary Practice Location 1

Location 11110 W Lake Cook Rd Ste 355Buffalo Grove, IL 60089-1991 · Phone (800) 564-0863

Other Providers at the Same Location NPPES 3

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

JESSICA PAXTON
Psychologist (Clinical)
10730 W 143RD ST STE 37
ORLAND PARK, IL 60462
Cook County (800) 564-0863
DR. JACQUELINE GRACE REA PHD, ABPP-CN
Clinical Neuropsychologist
10730 W 143RD ST STE 37
ORLAND PARK, IL 60462
Cook County (800) 564-0863
LAUREN CRISANTI PH.D.
Clinical Neuropsychologist
10730 W 143RD ST STE 37
ORLAND PARK, IL 60462
Cook County (800) 564-0863

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 Vicencio's NPI number?

The NPI number for Kenneth Vicencio is 1891211710. It was assigned to this individual provider in the NPPES registry on August 22, 2017.

Where is Kenneth Vicencio located?

Kenneth Vicencio practices at 10730 W 143rd St Ste 37, Orland Park, IL 60462. The listed phone number is (800) 564-0863.

What is Kenneth Vicencio's specialty?

The primary specialty registered for this NPI is Clinical Neuropsychologist with taxonomy code 103G00000X.

When was this NPI record last updated?

The NPPES record for Kenneth Vicencio was last updated on September 27, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.