Individual
DR. KATHRYN SUE BOHN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3302 GERIG DR, SUITE 100, BLOOMINGTON, IL 61704-6365
(309) 862-4000
(309) 862-4055
Mailing address
3302 GERIG DR, SUITE 100, BLOOMINGTON, IL 61704-6365
(309) 862-4000
(309) 862-4055
Taxonomy
Speciality
Code
Description
License number
State
202K00000X
Phlebology Physician
Primary
036071833
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036071833-1
—
IL
01
—
05721369
BC/BS
IL
Enumeration date
06/23/2006
Last updated
03/25/2014
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