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

Kent Tadokoro

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1285096602

Kent Tadokoro is an Otolaryngology in Maywood, Illinois. Graduated from Medical College of Wisconsin in 2016, 10 years ago. Practices with Southern California Permanente Medical Group, an 11,242-clinician group and accepts Medicare assignment.

Years since qualifying
10
Trained at
Medical College of Wisconsin
In the registry since
2016
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Practice location Address checks out

2160 S 1st Ave
Maywood, IL 60153-3328
Phone: (708) 216-1676
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Student in an Organized Health Care Education/Training Program (primary) Taxonomy 390200000X

Record details

NPI number1285096602
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedMarch 24, 2016
Last updated in NPPESSeptember 26, 2023
Certification dateJanuary 26, 2023
Mailing address2160 S 1st Ave, Maywood, IL 60153-3328

Medicare enrollment

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

Medicare specialtyOTOLARYNGOLOGY
Medical schoolMEDICAL COLLEGE OF WISCONSIN
Graduated 2016 (10 years in practice)
Group practice Southern California Permanente Medical Group — 11242 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations4 on file with Medicare

Other providers in Maywood