Individual
DR. RONALD E KIMBALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
509 W UNIVERSITY AVE, URBANA, IL 61801-1645
(217) 383-6636
(217) 383-3466
Mailing address
611 W. PARK ST., BWPC, URBANA, IL 61801-2500
(217) 383-6792
Taxonomy
Speciality
Code
Description
License number
State
207VX0201X
Gynecologic Oncology Physician
Primary
036128873
IL
207VX0201X
Gynecologic Oncology Physician
45330
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
018061
KAISER COMMERCIAL NUMBER
CO
05
—
52572731
—
CO
Enumeration date
10/26/2005
Last updated
05/26/2015
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