Dr. Kendall D Boone, M.D.
in Rockford, IL. Individual provider (NPI-1).
NPI number1861498909
StatusActive
Last updated in NPPESMar 21, 2024
Details
- NPI
- 1861498909
- Entity type
- Individual (NPI-1)
- Name
- Dr. Kendall D Boone
- Credential
- M.D.
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Jun 23, 2005
- Certification date
- Mar 21, 2024
- Last updated
- Mar 21, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2086S0129X | 036101179 | IL | Yes | |
| 2086S0127X | Surgery, Trauma Surgery | 036101179 | IL | |
| 2086S0129X | 66852 | WI |
Practice location
1340 Charles StRockford, IL 61104-2200
Phone 779-696-8799
Mailing address
7974 Uw Health CtMiddleton, WI 53562-5531
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