Kornblum, Jeffrey A
Kornblum, Jeffrey A is an individual health care provider with primary practice located at 602 W. University Avenue Neurosurgery, Urbana IL 61801. He recently has only one registered license in Allopathic & Osteopathic Physicians / Neurological Surgery, which is considered as his primary health care specialty. Kornblum, Jeffrey A can be contacted via phone (217) 383-3507.Contact Information
Primary practice address
602 W. University Avenue Neurosurgery
Urbana IL 61801
Phone: (217) 383-3507
Fax: (217) 383-3171
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Neurological Surgery | 207T00000X | E2806 | Arkansas |
Profile Details
| NPI number | 1306896170 |
|---|---|
| LBN Legal business name | Kornblum, Jeffrey A |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 11th, 2006 |
| Last updated | Dec 23rd, 2010 - about 14 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 | 1306896170 | NPPES |
| Arkansas | MEDICAID | 142431001 |
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