Caleb Pennock, in Carterville, IL - Licensed Practical Nurse

Caleb Pennock, is a Licensed Practical Nurse based in Carterville, Illinois. Caleb Pennock is licensed to practice in Illinois (license number 043.122929) and his current practice location is 4474 Old Route 13, Carterville, Illinois. He can be reached at his office (for appointments etc.) via phone at (618) 889-7076.

NPI number for Caleb Pennock is 1720535032 and his current mailing address is 4474 Old Route 13, Carterville, Illinois. He does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1720535032.

Contact Information

	Caleb Pennock,
	4474 Old Route 13, Carterville, IL 62918-3300
	(618) 889-7076
	Not Available

Provider's Profile

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.

NPI Data:

NPI Number: 1720535032
Provider Enumeration Date: 09/02/2016
Last Update Date: 09/02/2016

Medical Identifiers

Medical identifiers for Caleb Pennock such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1720535032	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
164W00000X	Licensed Practical Nurse	043.122929 (Illinois)	Primary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Caleb Pennock is NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

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

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Licensed Practical Nurse Nurses in Carterville, IL

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

Caleb Pennock, - Licensed Practical Nurse in Carterville, IL