Renick, Patrick Barry

Renick, Patrick Barry is an individual health care provider with primary practice located at 180 S Main St , Canton IL 61520-2608. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Renick, Patrick Barry can be contacted via phone (309) 647-0201.

Contact Information

Primary practice address
180 S Main St Canton IL 61520-2608
Phone: (309) 647-0201
Fax: (309) 649-6880
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 036119167 Illinois

Profile Details

NPI number 1760604193
LBN Legal business name Renick, Patrick Barry
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 3rd, 2007
Last updated Apr 13th, 2021 - about 4 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 1760604193 NPPES
Illinois MEDICAID 036119167

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