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Individual
KERRY L. HINCKS
Active
Individual
KERRY L. HINCKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
125-047892
IL
207Q00000X
Family Medicine Physician
Primary
Q7205
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036116570
—
IL
01
—
809840
MEDICARE GROUP #
IL
01
—
CA4079
RR GROUP #
IL
01
—
P00433545
RR INDIVIDUAL #
IL
Enumeration date
07/22/2006
Last updated
03/09/2022
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