Kettering, Todd Owen
Kettering, Todd Owen is an individual health care provider with primary practice located at 1300 Franklin Avenue, Suite 100 , Normal IL 61761. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Kettering, Todd Owen can be contacted via phone (309) 268-3761.Contact Information
Primary practice address
1300 Franklin Avenue, Suite 100
Normal IL 61761
Phone: (309) 268-3761
Fax: (309) 268-5620
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 34007709 | Ohio |
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 036.123240 | Illinois |
Profile Details
| NPI number | 1972619526 |
|---|---|
| LBN Legal business name | Kettering, Todd Owen |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 23rd, 2006 |
| Last updated | Aug 10th, 2022 - about 2 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 | 1972619526 | NPPES |
| Illinois | MEDICAID | 36123240 | |
| Illinois | MEDICAID | 2339713 | |
| Illinois | Other | 036-123240 |
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