Provider Demographics
NPI:1457396558
Name:FRANSEN AND KULB UROLOGY, LTD
Entity Type:Organization
Organization Name:FRANSEN AND KULB UROLOGY, LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:B
Authorized Official - Last Name:KULB
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:309-663-9424
Mailing Address - Street 1:1401 EASTLAND DR
Mailing Address - Street 2:SUITE B
Mailing Address - City:BLOOMINGTON
Mailing Address - State:IL
Mailing Address - Zip Code:61701-3514
Mailing Address - Country:US
Mailing Address - Phone:309-663-9424
Mailing Address - Fax:309-663-6350
Practice Address - Street 1:1401 EASTLAND DR
Practice Address - Street 2:SUITE B
Practice Address - City:BLOOMINGTON
Practice Address - State:IL
Practice Address - Zip Code:61701-3514
Practice Address - Country:US
Practice Address - Phone:309-663-9424
Practice Address - Fax:309-663-6350
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL5732045OtherGROUP BCBS PROVIDER
ILP00100008OtherRAILROAD MEDICARE
IL0723870001OtherGROUP DME PROVIDER NUMBER
ILG14718Medicare UPIN
IL798270Medicare ID - Type UnspecifiedGROUP PROVIDER NUMBER
IL0723870001OtherGROUP DME PROVIDER NUMBER
ILC48946Medicare UPIN