Van Kerrebroeck, Drew R
Van Kerrebroeck, Drew R is an individual health care provider with primary practice located at 600 N College Ave Suite 120, Geneseo IL 61254-1095. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Pediatrics. Allopathic & Osteopathic Physicians / Internal Medicine is his primary health care specialty. Van Kerrebroeck, Drew R can be contacted via phone (309) 946-5124.Contact Information
Primary practice address
600 N College Ave Suite 120
Geneseo IL 61254-1095
Phone: (309) 946-5124
Fax: (309) 721-1407
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 036106649 | Illinois |
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 036106649 | Illinois |
Profile Details
| NPI number | 1568440345 |
|---|---|
| LBN Legal business name | Van Kerrebroeck, Drew R |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 3rd, 2006 |
| Last updated | Jan 15th, 2014 - about 12 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1568440345 | NPPES |
| Illinois | Other | P00024916 | RR MEDICARE |
| Illinois | MEDICAID | 1568440345 | RR MEDICARE |
| Illinois | MEDICAID | 036106649 | RR MEDICARE |
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