Bohn, Kathryn Sue

Bohn, Kathryn Sue is an individual health care provider with primary practice located at 3302 Gerig Dr Suite 100, Bloomington IL 61704-6365. She recently has only one registered license in Allopathic & Osteopathic Physicians / Phlebology, which is considered as her primary health care specialty. Bohn, Kathryn Sue can be contacted via phone (309) 862-4000.

Contact Information

Primary practice address
3302 Gerig Dr Suite 100 Bloomington IL 61704-6365
Fax: (309) 862-4055
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Phlebology 202K00000X 036071833 Illinois

Profile Details

NPI number 1194751156
LBN Legal business name Bohn, Kathryn Sue
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 23rd, 2006
Last updated Mar 25th, 2014 - about 11 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 1194751156 NPPES
Illinois MEDICAID 036071833-1
Illinois Other 05721369

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