Organization
FRANSEN AND KULB UROLOGY, LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THOMAS KULB (PRESIDENT OF THE CORPORATION)
(309) 663-9424
Entity
Organization
Contact information
Practice address
2100 FORT JESSE RD, NORMAL, IL 61761-9370
(309) 834-4000
Mailing address
1401 EASTLAND DR, SUITE B, BLOOMINGTON, IL 61701-3514
(309) 663-9424
Taxonomy
Speciality
Code
Description
License number
State
261QL0400X
Lithotripsy Clinic/Center
Primary
7002512
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0723870001
DURABLE MEDICAL PROVIDER
IL
01
—
5732045
BCBS PROVIDER #
IL
01
—
P00100008
RR MEDICARE PROVIDER #
IL
Enumeration date
03/26/2007
Last updated
08/22/2020
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