Organization
KINDRED LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID H KINDRED MD (PHYSICIAN)
(309) 673-0000
Entity
Organization
Contact information
Practice address
120 NE GLEN OAK AVE, SUITE 200, PEORIA, IL 61603-4314
(309) 673-0000
(309) 673-3730
Mailing address
120 NE GLEN OAK AVE, SUITE 200, PEORIA, IL 61603-4314
(309) 673-0000
(309) 673-3730
Taxonomy
Speciality
Code
Description
License number
State
207VX0000X
Obstetrics Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
204931
PIN
IL
01
—
9032024
BLUE CROSS BLUE SHIELD
IL
Enumeration date
12/11/2006
Last updated
08/22/2020
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