# KINDRED LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1609936707
- **Authorized official:** DR. DAVID H KINDRED MD (PHYSICIAN)
- **Authorized official phone:** (309) 673-0000

## Contact information

- **Practice address:** 120 NE GLEN OAK AVE, SUITE 200, PEORIA, IL 61603-4314
- **Practice address phone:** (309) 673-0000
- **Practice address fax:** (309) 673-3730
- **Mailing address:** 120 NE GLEN OAK AVE, SUITE 200, PEORIA, IL 61603-4314
- **Mailing address phone:** (309) 673-0000
- **Mailing address fax:** (309) 673-3730

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207VX0000X | Obstetrics Physician | — | NULL | Yes |
| 207VX0000X | Obstetrics Physician | — | — | Yes |

## Other

- **Enumeration date:** 12/11/2006
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 204931 | PIN | IL |
| 01 | — | 9032024 | BLUE CROSS BLUE SHIELD | IL |