Mock, Kristin A

Mock, Kristin A is an individual health care provider with primary practice located at 954 West State Street , Sycamore IL 60118. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Mock, Kristin A can be contacted via phone (815) 895-9144.

Contact Information

Primary practice address
954 West State Street Sycamore IL 60118
Phone: (815) 895-9144
Fax: (815) 899-4234
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 036102009 Illinois

Profile Details

NPI number 1255380762
LBN Legal business name Mock, Kristin A
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 10th, 2006
Last updated Feb 9th, 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 1255380762 NPPES
Illinois MEDICAID 036102009

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