Bonnie J. Krodel, PA-C
Individual provider Active NPI Physician Assistant · Rock Falls, IL
NPI 1922324565 · NPPES record last updated Jul 18, 2017
Key facts
- NPI
- 1922324565
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- 085003715
- Practice address
- 1300 W 2ND St
Rock Falls, IL 61071-1005 - Phone
- (815) 626-2230
- NPI assigned
- Apr 7, 2010
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200319001895 | IL | Practitioner - Physician Assistant | 2163661323 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| County of Whiteside | Current |
Accepting new patients |
Locations
1300 W 2nd St
Rock Falls, IL 61071
Interoperability endpoints
- bonnie.krodel.p16@direct.fhn-fqhc.nextgenshare.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 085003715 | Yes |
Addresses
Primary practice location
1300 W 2ND St
Rock Falls, IL 61071-1005
Mailing address
1300 W 2ND St
Rock Falls, IL 61071-1005
Phone (815) 626-2230
Other providers in Rock Falls, IL
- Kirkland Family Chiropractic Center LTD
- Ashley Michelle Kirkland
- Joshua James Kirkland
- Brandon Richard Klein
- James Krenz
- Huy Van Le
- Lincare Inc.
- Eric Daniel Macak
- Carrie Eileen Mahar
- Amin Malaki
All providers in Rock Falls, IL · Physician Assistant in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 18, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.