Individual
DR. KEVIN D DRAXINGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1010 FAIRWAY DR, FREEPORT, IL 61032-6600
(815) 599-7730
Mailing address
421 W EXCHANGE ST, PO BOX 268, FREEPORT, IL 61032-4008
(815) 599-6000
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
036110748
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036110748
—
IL
01
—
097147
HEALTH ALLIANCE
IL
01
—
P00364766
RAILROAD MEDICARE
IL
Enumeration date
08/10/2006
Last updated
10/20/2017
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