Krock, Kenneth R.

Krock, Kenneth R. is an individual health care provider with primary practice located at 180 S Main St , Canton IL 61520-2608. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatrics, Allopathic & Osteopathic Physicians / Internal Medicine. Allopathic & Osteopathic Physicians / Internal Medicine is his primary health care specialty. Krock, Kenneth R. can be contacted via phone (309) 647-0201.

Contact Information

Primary practice address
180 S Main St Canton IL 61520-2608
Phone: (309) 647-0201
Fax: (309) 649-6880
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 036079829 Illinois
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 036079829 Illinois

Profile Details

NPI number 1699883868
LBN Legal business name Krock, Kenneth R.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 28th, 2006
Last updated Apr 7th, 2021 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1699883868 NPPES
Illinois Other 079829 OSF HEALTHPLANS
Illinois Other CG5172 OSF HEALTHPLANS
Illinois Other 02922981 OSF HEALTHPLANS
Illinois Other 200397 OSF HEALTHPLANS
Illinois Other 013495 OSF HEALTHPLANS
Illinois MEDICAID 036079829 OSF HEALTHPLANS
Illinois Other 194215197 OSF HEALTHPLANS
Illinois Other 0062839 OSF HEALTHPLANS
Illinois Other 110200867 OSF HEALTHPLANS
Illinois Other 180741 OSF HEALTHPLANS
Illinois Other IL0104 OSF HEALTHPLANS

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