Provider / Organization | NPI | Date Certified |
---|---|---|
CHARLES EARL SWANSON | 1811558638 | 2022-08-14 |
Charles Earl Swanson is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1811558638. Registration indicates Charles Earl Swanson is a provider of access to adult/geriatric primary care providers services with a specialization in Allopathic & Osteopathic Physicians, Internal Medicine Access to Pediatric Primary Care Providers (Allopathic & Osteopathic Physicians, Internal Medicine) (Internal Medicine, ) (Allopathic & Osteopathic Physicians, Internal Medicine) (Primary Care/Family Planning/APRN/PA, ) (Internal Medicine, Allopathic & Osteopathic Physicians)
Entity Type | Individual |
Provider Name | Dr. Charles Earl Swanson DO |
Practice Office Address | 350 N WALL ST KANKAKEE, IL US |
Practice Office Telephone | 8159286274 |
Mailing Address | 1256 SIOUX TURN KANKAKEE, IL 609018137 US |
Business Telephone | 8156001134 |
Code | Practice | License No State |
---|---|---|
207R00000X PRIMARY | Access to Adult/Geriatric Primary Care Providers Allopathic & Osteopathic Physicians Internal MedicineAccess to Pediatric Primary Care Providers Allopathic & Osteopathic Physicians Internal Medicine Internal Medicine Allopathic & Osteopathic Physicians Internal Medicine Primary Care/Family Planning/APRN/PA Internal Medicine Allopathic & Osteopathic Physicians | 036.160864
IL |