Boone, Kendall D

Boone, Kendall D is an individual health care provider with primary practice located at 1340 Charles St , Rockford IL 61104-2200. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Trauma Surgery, Allopathic & Osteopathic Physicians / Vascular Surgery. Allopathic & Osteopathic Physicians / Vascular Surgery is his primary health care specialty. Boone, Kendall D can be contacted via phone (779) 696-8799.

Contact Information

Primary practice address
1340 Charles St Rockford IL 61104-2200
Phone: (779) 696-8799
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Trauma Surgery 2086S0127X 036101179 Illinois
Allopathic & Osteopathic Physicians / Vascular Surgery 2086S0129X 66852 Wisconsin
Allopathic & Osteopathic Physicians / Vascular Surgery 2086S0129X 036101179 Illinois

Profile Details

NPI number 1861498909
LBN Legal business name Boone, Kendall D
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 23rd, 2005
Last updated Mar 21st, 2024 - about 9 months 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 1861498909 NPPES
Illinois Other 2045754001 OWCP
Illinois Other 194273 OWCP

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