Kevin Philip Wakeman | St Charles, IL • PECOS Search

Kevin Philip Wakeman

Family Medicine

Allopathic & Osteopathic Physicians

2900 Foxfield Rd, St Charles, IL 60174-5799

(630) 377-6500 (847) 836-9419

PECOS Enrollment

Based on the most recent information from CMS, provider Kevin Philip Wakeman does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records 2 days ago.

Profile Details

Provider ID
1356459879
Provider Type
Individual
Full Name
Wakeman, Kevin Philip
Title
Dr.
Credential
MD

Gender
Male
Sole Proprietor
No
Enumeration Date
8/25/2006
Last Updated
7/9/2007

Contact Information

Practice Location

2900 Foxfield Rd, St Charles, IL 60174-5799

Unlisted Fax

Mailing Location

1571 Southridge Trl, Algonquin, IL 60102-6602

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 207Q00000X Primary	Description Family Medicine Allopathic & Osteopathic Physicians	License Unlisted Issuer Illinois