Individual
KEVIN PATRICK KERN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Taxonomy
Speciality
Code
Description
License number
State
202K00000X
Phlebology Physician
Primary
036101395
IL
207P00000X
Emergency Medicine Physician
036101395
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
789511
GROUP MEDICARE PTAN
IL
01
—
79510
GROUP MEDICARE PTAN
IL
Enumeration date
06/30/2006
Last updated
01/24/2024
Update your record
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