Individual
KATHY D. SWAFFORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
300 W OAK ST, CARBONDALE, IL 62901-1400
(618) 536-6621
Mailing address
201 E MADISON ST STE 328, SPRINGFIELD, IL 62702-5131
(217) 545-8000
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
036074783
IL
2080C0008X
Child Abuse Pediatrics Physician
036074783
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
021175
HEALTH ALLIANCE
IL
05
—
036074783
—
IL
01
—
09122971
BLUE CROSS/BLUE SHIELD
IL
01
—
102371
HEALTHLINK
IL
Enumeration date
10/21/2005
Last updated
06/13/2024
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