Individual
KEVIN J DARDIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1000 MINERAL POINT AVE, JANESVILLE, WI 53548-2940
(608) 756-6611
(608) 756-6177
Mailing address
29624 NETWORK PL, CHICAGO, IL 60673-1296
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
036090958
IL
207P00000X
Emergency Medicine Physician
Primary
53250-21
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036090958 1
—
IL
01
—
1609894526
BCBSWI
WI
05
—
1609894526
—
WI
01
—
DARDIKEV
MERCYCARE INSURANCE
WI
01
—
P00767435CD3624
RR MEDICARE
WI
01
—
P00959255DR7136
RR MEDICARE
IL
Enumeration date
07/18/2006
Last updated
08/08/2024
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