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

Michael Niel Fenner, MD

Individual provider Surgery Physician · NPI 1578660445

Michael Niel Fenner, MD is a Surgery Physician in Jacksonville, Illinois. Licensed in Alaska and Illinois. Registered with an NPI since 2006.

Licensed in
AK, IL
In the registry since
2006
Specialties on file
2
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

1600 W Walnut St
Jacksonville, IL 62650-1136
Phone: (217) 528-7541
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Surgery Physician (primary) Taxonomy 208600000X · Licence 036080188 (IL)
Surgery Physician Taxonomy 208600000X · Licence 5616 (AK)

Record details

NPI number1578660445
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedSeptember 20, 2006
Last updated in NPPESFebruary 4, 2021
Certification dateFebruary 4, 2021
Mailing address1025 S 6th St, Springfield, IL 62703-2403

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