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Caleb Pennock
NPI 1720535032 · on the registry since 2016 · sole proprietor
Practice
- Address
- 4474 Old Route 13
Carterville, IL 62918 - Phone
- (618) 889-7076
Registry record
- Primary taxonomy
- 164W00000X
164W00000X
- Licence states on file
- IL
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2016-09-02
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Illinois