Doctor Name: | MR. LE KENOBBIE |
NPI Number: | 1518938562 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | CRNA |
License Number: | |
Business Practice Address: | 304 N Park Forest Dr Robinson, IL - 624541248 |
Business Phone Number: | 6185448851 |
Business Fax Number: | |
Mailing Address: | 304 N Park Forest Dr, ROBINSON |
State: | IL |
Postal Code: | 624541248 |
Phone Number: | 6185448851 |
Fax Number: | |
NPI Enumeration Date: | 01/29/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |