Oliver, Kevin M

Oliver, Kevin M is an individual health care provider with primary practice located at 1800 E Lake Shore Dr , Decatur IL 62521-3810. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Emergency Medicine, Allopathic & Osteopathic Physicians / Family Medicine. Allopathic & Osteopathic Physicians / Emergency Medicine is his primary health care specialty. Oliver, Kevin M can be contacted via phone (217) 464-2973.

Contact Information

Primary practice address
1800 E Lake Shore Dr Decatur IL 62521-3810
Phone: (217) 464-2973
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X R8J38 Missouri
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X R8J38 Missouri
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 036-116436 Illinois

Profile Details

NPI number 1477549020
LBN Legal business name Oliver, Kevin M
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 20th, 2005
Last updated Dec 17th, 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 1477549020 NPPES
Illinois MEDICAID 036116436
Illinois MEDICAID 243001013

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