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Dr. Kendall D Boone, MD
Vascular Surgery Physician in Rockford, Illinois
NPI 1861498909

Kendall D Boone is a Vascular Surgery Physician based in Middleton, IL and is specialized in Vascular Surgery. Kendall D Boone practices in Rockford, IL and has the professional credentials of MD. The NPI Number for Kendall D Boone is 1861498909 and holds a License No. 036101179 (Illinois).

The current practice location address for Kendall D Boone is 1340 Charles St, Rockford, IL and can be reached out via phone at 779-696-8799.

Location: 1340 Charles St, Rockford, IL, 53562-5531
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1861498909
Provider Name
Kendall D Boone
Credential
MD
Provider Entity Type
Individual
Gender
Male
Address
1340 Charles St, Rockford, IL, 53562-5531
Phone Number
779-696-8799
Fax Number
Provider Enumeration Date
06/23/2005
Last Update Date
04/13/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
2045754001 01 IL OWCP
194273 01 IL PERSONAL CARE
institution
Provider Business Practice Location Address Details
Address
1340 Charles St
City
Rockford
State
Illinois
Zip
61104-2200
Phone Number
779-696-8799
Fax Number
person
Provider Business Mailing Address Details
Address
1340 Charles St
City
Rockford
State
Illinois
Zip
61104-2200
Phone Number
779-696-8799
Fax Number
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
Surgery
Speciality
Trauma Surgery
Taxonomy
2086S0127X
License No.
66852 (Wisconsin)
Definition
Trauma surgery is a recognized subspecialty of general surgery. Trauma surgeons are physicians who have completed a five-year general surgery residency and usually continue with a one to two year fellowship in trauma and/or surgical critical care, typically leading to additional board certification in surgical critical care. There is no trauma surgery board certification at this point. To obtain board certification in surgical critical care, a fellowship in surgical critical care or anesthesiology critical care must be completed during or after general surgery residency.
person
Provider's Taxonomy Details 2
Type
Allopathic & Osteopathic Physicians
Classification
Surgery
Speciality
Vascular Surgery
Taxonomy
2086S0129X
License No.
036101179 (Illinois)
Definition
A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart.
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