Bethke, Kevin

Bethke, Kevin is an individual health care provider with primary practice located at 676 N Saint Clair St Suite 1525A, Chicago IL 60611-2927. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Bethke, Kevin can be contacted via phone (312) 943-2746.

Contact Information

Primary practice address
676 N Saint Clair St Suite 1525A Chicago IL 60611-2927
Phone: (312) 943-2746
Fax: (312) 266-1411
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X Illinois

Profile Details

NPI number 1356338883
LBN Legal business name Bethke, Kevin
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 30th, 2005
Last updated Jul 8th, 2007 - about 18 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 1356338883 NPPES
Illinois Other 01621690 BLUE SHIELD

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