Individual
DR. KENDALL D BOONE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
2086S0127X
Trauma Surgery Physician
036101179
IL
2086S0129X
Vascular Surgery Physician
Primary
036101179
IL
2086S0129X
Vascular Surgery Physician
66852
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
194273
PERSONAL CARE
IL
01
—
2045754001
OWCP
IL
Enumeration date
06/23/2005
Last updated
03/21/2024
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