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Individual

DR. DEBRA C DRENGENBERG

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
1107 S. DIVISION AVE., KSB CENTER FOR HEALTH SERVICES/POLO, POLO, IL 61064
(815) 946-3453
(815) 946-3908
Mailing address
1107 S DIVISION AVE, KSB CENTER FOR HEALTH SERVICES/POLO, POLO, IL 61064-1875
(815) 946-3453
(815) 946-3908

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036-101870
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
036101870
IL
01
L88519
MEDICARE
IL
Enumeration date
01/27/2006
Last updated
08/21/2018
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