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Mr. Theodore Craig Brock, APN-BC
Nurse Practitioner in Geneva, Illinois
NPI 1386070480

Theodore Craig Brock is a Nurse Practitioner based in Geneva, IL. Theodore Craig Brock practices in Geneva, IL and has the professional credentials of APN-BC. The NPI Number for Theodore Craig Brock is 1386070480 and holds a License No. 209010570 (Illinois).

The current practice location address for Theodore Craig Brock is 304 Randall Rd, Geneva, IL and can be reached out via phone at 630-232-0610 and via fax at 630-232-0675.

Location: 304 Randall Rd, Geneva, IL, 60134-4200
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1386070480
Provider Name
Theodore Craig Brock
Credential
APN-BC
Provider Entity Type
Individual
Gender
Male
Address
304 Randall Rd, Geneva, IL, 60134-4200
Phone Number
630-232-0610
Fax Number
630-232-0675
Provider Enumeration Date
09/20/2013
Last Update Date
05/18/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
041303225 01 IL MEDICAID
CA4748 01 IL MEDICARE RAILROAD (GROUP)
P01349683 01 IL MEDICARE RAILROAD (INDIVIDUAL)
206147 01 IL MEDICARE PTAN (GROUP)
F400112507 01 IL MEDICARE PTAN (INDIVIDUAL)
institution
Provider Business Practice Location Address Details
Address
304 Randall Rd
City
Geneva
State
Illinois
Zip
60134
Phone Number
630-232-0610
Fax Number
630-232-0675
person
Provider Business Mailing Address Details
Address
304 Randall Rd
City
Geneva
State
Illinois
Zip
60134
Phone Number
630-232-0610
Fax Number
630-232-0675
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
-
Taxonomy
363L00000X
License No.
209010570 (Illinois)
Definition
(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.
person
Provider's Taxonomy Details 2
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Adult Health
Taxonomy
363LA2200X
License No.
209010570 (Illinois)
Definition
Definition to come...
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