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Individual
KENNETH MAX EAKIN
Active
Individual
KENNETH MAX EAKIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036066196
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0107335
UNITED HEALTHCARE
—
05
—
036066196
—
IL
01
—
080021116
RR MEDICARE
IL
01
—
118802
HEALTHLINK
—
01
—
371205888
TAX ID
—
01
—
4622029
ADMINISTAR
IL
01
—
N4882
GROUP HEALTH PLAN
—
Enumeration date
06/22/2005
Last updated
04/30/2008
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