Kimberly Ann Pennock in Waterloo - Clinical
Kimberly Ann Pennock - NPI 1073659504
Kimberly Ann Pennock is a Clinical in Waterloo, Illinois. Kimberly Ann Pennock practices all healthcare services and medical treatments related to Clinical. The NPI Number for Kimberly Ann Pennock is 1073659504. The last update date is 2007-07-08.
Kimberly Ann Pennock's current location address is 988 N Illinois Route 3, Waterloo, Illinois. You can contact this provider via phone number 6189394444 and fax number 6189394181. The mailing address for Kimberly Ann Pennock is 988 N Illinois Route 3, Waterloo, Illinois. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Kimberly Ann Pennock |
|---|---|
| Address | 988 N Illinois Route 3, Waterloo, Illinois |
| Phone Number | 6189394444 |
| Fax Number | 6189394181 |
| Sole Proprietor | N |
| Credentials | LCSW |
NPI Number Detail
| NPI Number | 1073659504 |
|---|---|
| Provider Enumeration Date | 2007-01-30 |
| Last Updated Date | 2007-07-08 |
Provider Mailing Address Detail
| Address | 988 N Illinois Route 3 |
|---|---|
| City | Waterloo |
| State | Illinois (IL) |
| Post Code | 6229810000 |
| Phone Number | 6189394444 |
| Fax Number | 6189394181 |
Provider's Primary Taxonomy Detail
| Speciality | Clinical |
|---|---|
| Taxonomy | 1041C0700X |
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Definition: A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certif |
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Post Comment/ Review Below
What is the unique 10-digit identifier code assigned to Kimberly Ann Pennock by the Centers for Medicare & Medicaid Services?
The Kimberly Ann Pennock has been issued the NPI (National Provider Identifier) 1073659504 by the CMS (Centers for Medicare & Medicaid Services), which serves as a unique identification number for healthcare providers.
Could you provide the complete address where Kimberly Ann Pennock is physically located?
The Kimberly Ann Pennock is situated at the following address: 988 N Illinois Route 3, Waterloo, IL 6229810000.
What is Kimberly Ann Pennock's specialized area of practice, and what is the corresponding taxonomy classification code for this field?
The Kimberly Ann Pennock's specialized field of practice is Clinical, and the corresponding taxonomy code that categorizes this area of specialization is 1041C0700X.
On what date did Kimberly Ann Pennock receive its 1073659504 assignment from the Centers for Medicare & Medicaid Services?
The Kimberly Ann Pennock was assigned its 1073659504 on 2007-01-30, which is the date when this unique identifier was issued to the organization by the Centers for Medicare & Medicaid Services.
As of what date was the information regarding Kimberly Ann Pennock, such as address, specialty, and other details, last verified and confirmed to be up-to-date?
The information related to Kimberly Ann Pennock, including its address, specialty, and other relevant details, was last verified and confirmed to be up-to-date on 2007-07-08.