Individual
KEVIN D OESTMANN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
405 RUSHING DRIVE, HERRIN, IL 62948
(618) 993-3300
(618) 993-0262
Mailing address
PO BOX 3988, CARBONDALE, IL 62902-3988
(618) 457-5200
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036074512
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
033353
HEALTH ALLIANCE
—
05
—
036074512
—
IL
01
—
080075456
RAILROAD MEDICARE
—
01
—
10019630
BLUE CROSS/BLUE SHIELD
—
01
—
148485
HEALTHLINK
—
Enumeration date
08/24/2006
Last updated
09/27/2021
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