Provider Demographics
NPI:1922623321
Name:MAY, KABLE (PA)
Entity type:Individual
Prefix:
First Name:KABLE
Middle Name:
Last Name:MAY
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:KABLE
Other - Middle Name:
Other - Last Name:CROW
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 3428
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:62708-3428
Mailing Address - Country:US
Mailing Address - Phone:217-243-0300
Mailing Address - Fax:217-862-0202
Practice Address - Street 1:15 FOUNDERS LN
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:IL
Practice Address - Zip Code:62650-3919
Practice Address - Country:US
Practice Address - Phone:217-243-0300
Practice Address - Fax:217-245-6775
Is Sole Proprietor?:No
Enumeration Date:2020-06-11
Last Update Date:2023-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL085.008347363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant