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

Mr. Kenneth Ildefonso Jr., ATR

Individual provider Athletic Trainer · NPI 1518356427

Mr. Kenneth Ildefonso Jr., ATR is an Athletic Trainer in Mankato, Minnesota. Practices as a sole proprietor. Licensed in Minnesota.

Licensed in
MN
In the registry since
2015

Practice location Address checks out

1801 Monks Ave Apt 413
Mankato, MN 56001-6356
Phone: (203) 584-3347
Show map & directions

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

Specialties & licences

Athletic Trainer (primary) Taxonomy 2255A2300X · Licence 2474 (MN)

Record details

NPI number1518356427
Entity typeIndividual (Type 1)
GenderMale
Credentials ATR
Sole proprietorYes
NPI enumeratedJanuary 15, 2015
Last updated in NPPESJanuary 15, 2015

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