Kim Fonner is a Pediatrics in Mattoon, Illinois. Kim Fonner practices all healthcare services and medical treatments related to Pediatrics. The NPI Number for Kim Fonner is 1174748354. The last update date is 2017-08-28.
Kim Fonner's current location address is 3395 W Lake Paradise Rd, Mattoon, Illinois. You can contact this provider via phone number 2172342327. The mailing address for Kim Fonner is 3395 W Lake Paradise Rd, Mattoon, Illinois. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Kim Fonner |
|---|---|
| Address | 3395 W Lake Paradise Rd, Mattoon, Illinois |
| Phone Number | 2172342327 |
| Fax Number | |
| Sole Proprietor | Y |
| Credentials | -- |
NPI Number Detail
| NPI Number | 1174748354 |
|---|---|
| Provider Enumeration Date | 2007-04-14 |
| Last Updated Date | 2017-08-28 |
Provider Mailing Address Detail
| Address | 3395 W Lake Paradise Rd |
|---|---|
| City | Mattoon |
| State | Illinois (IL) |
| Post Code | 619388969 |
| Phone Number | 2172342327 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Pediatrics |
|---|---|
| Taxonomy | 225Xp0200X |
| Licence No | 56008777 |
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Definition: Occupational therapists provide services to infants, toddlers and children who have or who are at risk for developmental delays or disabilities. Occupational therapy is concerned with a child's ability to participate in daily life activities or "occu |
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What is the Kim Fonner's unique identification number?
The Kim Fonner has been assigned the NPI (National Provider Identifier) Number 1174748354 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for the organization.
Could you please provide the complete street address where Kim Fonner is physically located?
The Kim Fonner is physically situated at the following address: 3395 W Lake Paradise Rd, Mattoon, IL, 619388969.
What is Kim Fonner's primary field of medical specialization, and what is the corresponding taxonomy classification code for this area of expertise?
The primary field of medical specialization for Kim Fonner is Pediatrics, and the taxonomy classification code that categorizes this area of expertise is 225Xp0200X.
On what date did the Centers for Medicare & Medicaid Services issue the 1174748354 to Kim Fonner?
The Kim Fonner received its 1174748354 assignment from the Centers for Medicare & Medicaid Services on 2007-04-14.
When was the Kim Fonner's information last updated?
The Kim Fonner's information was last updated on 2017-08-28.