DR. KEVIN ALLEN BRUCKER (NPI# 1295807154) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295807154 |
| Entity Type | Individual |
| Full Name | DR. KEVIN ALLEN BRUCKER |
| Credential | D.M.D. |
| Practice Address |
2 Doctors Park Gibson City IL 60936-2000 |
| Mailing Address |
2 Doctors Park P. O. Box 206 Gibson City IL 60936-2000 |
| Practice Telephone | 2177844455 |
| Practice Fax Number | 2177844383 |
| Mailing Telephone | 2177844455 |
| Mailing Fax Number | 2177844383 |
| Enumeration Date | 2006-11-15 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
019023571 | IL | Dental Providers |
| Street Address |
2 DOCTORS PARK |
| City | GIBSON CITY |
| State | IL |
| Zip Code | 60936-2000 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073738738 | Carrie Ann Lithgow | Physical Therapist | 109 N. Sangamon Ave, Gibson City, IL 60936 | 2007-04-16 |
| 1144359001 | Kerrie Ann Patrick | Registered Nurse | 222 N Sangamon, Gibson City, IL 60936 | 2007-03-05 |
| 1578612800 | Donna J Boundy | Dentist | 627 E 8th St, Gibson City, IL 60936 | 2007-01-09 |
| 1093878241 | Drew Curtis Duquette | Chiropractor | 523 and One Half South Sangamon Ave, Gibson City, IL 60936 | 2006-12-19 |
| 1386727642 | Amnuay Sethakorn | Family Medicine | 4 Doctors Park, Gibson City, IL 60936 | 2006-10-23 |
| 1689687295 | Alexander V Grandt | Nurse Practitioner | 1120 N Melvin, Gibson Area Hospital & Health Services, Gibson, IL 60936 | 2006-08-14 |
| 1811125784 | Gibson Community Hospital Association | Surgery | 1 Doctors Park, Gibson City, IL 60936 | 2009-06-30 |
| 1295991701 | Trilok Shah | Psychiatry & Neurology | 4 Doctors Park, Gibson City, IL 60936 | 2008-08-04 |
| 1013050046 | Rebecca Anne Wildermuth | Specialist/Technologist | 10 Doctors Park, Gibson City, IL 60936 | 2007-02-15 |
| 1245312602 | Ginny E Pulley | Licensed Practical Nurse | 222 N Sangamon Ave, Gibson City, IL 60936 | 2006-10-19 |
| Find all providers in zip 60936 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992714349 | Douglas Vaughn Schultz | Dentist | 330 N Sangamon Ave, Gibson City, IL 60936-1256 | 2006-08-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104425230 | Sundeep Franklin Dmd & Daiana Capota Dmd Pllc | Dentist | 320 N Mclean Blvd Ste B, Elgin, IL 60123-3220 | 2020-10-20 |
| 1801403555 | Stephanie Elizabeth Miller | Dentist | 2220 Sisters Ave, Naperville, IL 60564-4394 | 2020-09-27 |
| 1417564121 | Gursimran Reen, Dmd LLC | Dentist | 29 S Webster St Ste 108, Naperville, IL 60540-5353 | 2020-09-26 |
| 1285240531 | Summit Dental Center LLC | Dentist | 7710 W 62nd Pl, Summit, IL 60501-1702 | 2020-09-22 |
| 1295340628 | Karina Valentin | Dentist | 1534 N Oakley Blvd Apt 3f, Chicago, IL 60622-1783 | 2020-09-11 |
| 1932713583 | Kevin G Reardon | Dentist | 479 S Spring Rd, Elmhurst, IL 60126-3857 | 2020-09-01 |
| 1831702307 | Sms Dental LLC | Dentist | 17727 Halsted St, Homewood, IL 60430 | 2020-08-25 |
| 1548870884 | Daniel Patrick Jurgens | Dentist | 2 N Country Club Rd Ste 2, Decatur, IL 62521-4174 | 2020-08-02 |
| 1184233934 | Shawna Jade Dudovitz | Dentist | 309 Tamarack Ln, Shiloh, IL 62269-2993 | 2020-07-28 |
| 1417565748 | Robert Hails | Dentist | 3540 N Belt W Ste B, Belleville, IL 62226-5975 | 2020-07-22 |
| Find all providers with the same taxonomy | ||||
| City | GIBSON CITY |
| Zip Code | 60936 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.