Cradock, Kimberly A
Cradock, Kimberly A is an sole proprietor health care provider with primary practice located at 602 W. University Avenue General Surgery, Urbana IL 61801. She recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as her primary health care specialty. Cradock, Kimberly A can be contacted via phone (217) 383-3240.Contact Information
Primary practice address
602 W. University Avenue General Surgery
Urbana IL 61801
Phone: (217) 383-3240
Fax: (217) 383-4597
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Surgery | 208600000X | 036116793 | Illinois |
Profile Details
| NPI number | 1659483204 |
|---|---|
| LBN Legal business name | Cradock, Kimberly A |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Aug 31st, 2006 |
| Last updated | Jun 5th, 2012 - about 13 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 | 1659483204 | NPPES |
| Illinois | MEDICAID | 6447860011 |
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