Eakin, Kenneth Max

Eakin, Kenneth Max is an individual health care provider with primary practice located at 3 Junction Dr W , Glen Carbon IL 62034-2916. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Eakin, Kenneth Max can be contacted via phone (618) 288-5088.

Contact Information

Primary practice address
3 Junction Dr W Glen Carbon IL 62034-2916
Phone: (618) 288-5088
Fax: (618) 288-9153
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 036066196 Illinois

Profile Details

NPI number 1174529556
LBN Legal business name Eakin, Kenneth Max
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 22nd, 2005
Last updated Apr 30th, 2008 - about 16 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 1174529556 NPPES
Illinois Other 080021116 RR MEDICARE
Illinois Other 0107335 RR MEDICARE
Illinois Other 371205888 RR MEDICARE
Illinois Other 118802 RR MEDICARE
Illinois Other N4882 RR MEDICARE
Illinois MEDICAID 036066196 RR MEDICARE
Illinois Other 4622029 RR MEDICARE

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