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DENNIS DAN BIRKY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
701 E ORANGE ST, HOOPESTON, IL 60942-1801
(217) 283-5531
(217) 748-6231
Mailing address
701 E ORANGE ST, HOOPESTON, IL 60942-1801
(217) 283-5531
(217) 283-7981

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
125861
MO
367500000X
Certified Registered Nurse Anesthetist
28069877A
IN
367500000X
Certified Registered Nurse Anesthetist
APN0000011571
TN
367500000X
Certified Registered Nurse Anesthetist
Primary
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000485518
ANTHEM PIN NUMBER
IN
01
11573787
CAQH NUMBER
IN
01
9447676
PHCS PID NUMBER
IN
Enumeration date
05/23/2006
Last updated
07/23/2007
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