Individual
DR. KENNETH B CAMACHO
Active
Individual
DR. KENNETH B CAMACHO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
036101777
IL
207RG0100X
Gastroenterology Physician
57390
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036101777
—
IL
01
—
067597
HEALTH ALLIANCE
IL
01
—
07215152
BLUE CROSS
IL
01
—
100014760
RAILROAD MEDICARE
IL
01
—
371221637
FEDERAL TAX ID
IL
01
—
426249
HEALTHLINK
IL
01
—
7036279
AETNA HEALTH PLANS
IL
05
—
7100877910
—
KY
01
—
776530
MEDICARE GROUP NUMBER
IL
01
—
IL0114
JOHN DEERE
IL
Enumeration date
06/10/2006
Last updated
06/26/2023
Update your record
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