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Dustin Kern
Student in an Organized Health Care Education/Training Program in Peoria, Illinois
NPI 1750517488

Dustin Kern is a Student in an Organized Health Care Education/Training Program based in Peoria, IL. Dustin Kern practices in Peoria, IL. The NPI Number for Dustin Kern is 1750517488 and holds a License No. 041-339058 (Illinois).

The current practice location address for Dustin Kern is 8600 N State Route 91, Peoria, IL and can be reached out via phone at 309-692-5394 and via fax at 309-692-2272.

Location: 8600 N State Route 91, Peoria, IL, 61615-9541
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1750517488
Provider Name
Dustin Kern
Credential
Provider Entity Type
Individual
Gender
Male
Address
8600 N State Route 91, Peoria, IL, 61615-9541
Phone Number
309-692-5394
Fax Number
309-692-2272
Provider Enumeration Date
06/09/2009
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
PENDING 01 IL MEDICARE
institution
Provider Business Practice Location Address Details
Address
8600 N State Route 91
City
Peoria
State
Illinois
Zip
61615-9541
Phone Number
309-692-5394
Fax Number
309-692-2272
person
Provider Business Mailing Address Details
Address
8600 N State Route 91
City
Peoria
State
Illinois
Zip
61615-9541
Phone Number
309-692-5394
Fax Number
309-692-2272
person
Provider's Taxonomy Details 1
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
041-339058 (Illinois)
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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