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

Kenneth Vicencio, PSYD

Individual provider Clinical Neuropsychologist · NPI 1891211710

Kenneth Vicencio, PSYD is a Clinical Neuropsychologist in Orland Park, Illinois. Works from 2 locations. Licensed in Illinois.

Licensed in
IL
In the registry since
2017
Specialties on file
2
What do these letters mean?
PSYD — Doctor of Psychology
A doctoral psychologist trained primarily for clinical practice.

See every abbreviation used in this directory →

Practice location Address checks out

10730 W 143rd St Ste 37
Orland Park, IL 60462-1940
Phone: (800) 564-0863
Show map & directions

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

Additional practice locations (1)

  • 1110 W Lake Cook Rd Ste 355, Buffalo Grove, IL 60089-1991 — (800) 564-0863

Specialties & licences

Clinical Neuropsychologist (primary) Taxonomy 103G00000X · Licence 071009682 (IL)
Clinical Neuropsychologist Taxonomy 103G00000X

Record details

NPI number1891211710
Entity typeIndividual (Type 1)
GenderMale
Credentials PSYD
Sole proprietorNo
NPI enumeratedAugust 22, 2017
Last updated in NPPESSeptember 27, 2022
Certification dateSeptember 27, 2022
Mailing address10730 W 143rd St Ste 37, Orland Park, IL 60462-1940

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