Individual
DR. KIMBERLY M. EICKMEIER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.P.M.
Contact information
Practice address
411 DEVONSHIRE DR, CHAMPAIGN, IL 61820-7286
(217) 352-2573
Mailing address
4701 BRITTANY TRAIL DR, CHAMPAIGN, IL 61822-3549
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
016004729
IL
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
016004729
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
016004729 1
—
IL
01
—
480018421
RAILROAD MEDICARE
IL
01
—
909010
MEDICARE GROUP
IL
Enumeration date
08/01/2006
Last updated
06/07/2022
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