Individual
KENNETH ARNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
200 E PENNSYLVANIA AVE, PEORIA, IL 61603-3089
(309) 655-4184
(309) 624-8876
Mailing address
200 E PENNSYLVANIA AVE, PEORIA, IL 61603-3089
(309) 655-4184
(309) 624-8876
Taxonomy
Speciality
Code
Description
License number
State
207KA0200X
Allergy Physician
Primary
036-064666
IL
207RP1001X
Pulmonary Disease Physician
036-064666
IL
208000000X
Pediatrics Physician
036-064666
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036064666
—
IL
Enumeration date
10/16/2006
Last updated
01/10/2012
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