| Caleb Pennock, | |
|
4474 Old Route 13, Carterville, IL 62918-3300 | |
| (618) 889-7076 | |
| Not Available |
| Full Name | Caleb Pennock |
|---|---|
| Gender | Male |
| Speciality | Licensed Practical Nurse |
| Location | 4474 Old Route 13, Carterville, Illinois |
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720535032 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 164W00000X | Licensed Practical Nurse | 043.122929 (Illinois) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Caleb Pennock, 4474 Old Route 13, Carterville, IL 62918-3300 Ph: () - | Caleb Pennock, 4474 Old Route 13, Carterville, IL 62918-3300 Ph: (618) 889-7076 |
Jennifer Sue Derosia, LPN Licensed Practical Nurse Medicare: Not Enrolled in Medicare Practice Location: 403 Municipal Dr, Carterville, IL 62918 Phone: 855-608-3560 Fax: 618-956-9349 | |
Jacob Kierbs, Licensed Practical Nurse Medicare: Not Enrolled in Medicare Practice Location: 1216 Hummingbird Ct, Carterville, IL 62918 Phone: 217-855-1760 | |
Mrs. Angela Congiardo, LPN Licensed Practical Nurse Medicare: Not Enrolled in Medicare Practice Location: 713 Vermont Rd, Carterville, IL 62918 Phone: 618-694-3963 | |
Mrs. Breanne Nicole Mekelburg, LPN Licensed Practical Nurse Medicare: Not Enrolled in Medicare Practice Location: 317 Texas Ave, Carterville, IL 62918 Phone: 618-203-3954 |