Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Geoffrey C Fenner, MD

Individual provider Plastic Surgery Physician · NPI 1629176003

Geoffrey C Fenner, MD is a Plastic and Reconstructive Surgery in Kenilworth, Illinois. Graduated from Indiana University School of Medicine in 1988, 38 years ago. Practices as a sole proprietor and accepts Medicare assignment. Licensed in Illinois.

Years since qualifying
38
Trained at
Indiana University School of Medicine
Licensed in
IL
In the registry since
2006
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

512 Green Bay Rd
Kenilworth, IL 60043
Phone: (847) 716-2400
Fax: (847) 716-2401
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Plastic Surgery Physician (primary) Taxonomy 208200000X · Licence 036081864 (IL)

Record details

NPI number1629176003
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorYes
NPI enumeratedSeptember 20, 2006
Last updated in NPPESOctober 29, 2020
Certification dateOctober 29, 2020
Mailing address512 Green Bay Road, Kenilworth, IL 60043

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPLASTIC AND RECONSTRUCTIVE SURGERY
Also practisesGENERAL SURGERY
Medical schoolINDIANA UNIVERSITY SCHOOL OF MEDICINE
Graduated 1988 (38 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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