Individual
KENNTH ALAN HODEL
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6915 N KNOXVILLE AVE, SUITE 1, PEORIA, IL 61614-2851
(309) 683-8910
(309) 683-8911
Mailing address
6915 N KNOXVILLE AVE, SUITE 1, PEORIA, IL 61614
(309) 683-8910
(309) 683-8911
Taxonomy
Speciality
Code
Description
License number
State
207VX0201X
Gynecologic Oncology Physician
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
A24511
—
IL
Enumeration date
03/09/2006
Last updated
07/08/2007
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