Individual
KEVIN IZQUIERDO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
300 W OAK ST STE 200, CARBONDALE, IL 62901-1400
(618) 536-6621
Mailing address
300 W OAK ST STE 200, CARBONDALE, IL 62901-1400
(618) 536-6621
Taxonomy
Speciality
Code
Description
License number
State
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
125.086053
IL
Other
Enumeration date
08/25/2020
Last updated
12/22/2025
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