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KISHWAUKEE CORPORATE HEALTH @MOI NPI 1467841809


NPI Information

NPI: 1467841809
Provider Name: KISHWAUKEE CORPORATE HEALTH @MOI
Classification: Clinic/Center - 261QX0100X
Entity Type: Organization

Specialization: Occupational Medicine

Address:
2111 MIDLANDS CT
SUITE 201
SYCAMORE, IL
ZIP 60178
Phone: (181) 575-4488
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KISHWAUKEE CORPORATE HEALTH @MOI is an occupational medicine clinic center in Sycamore, IL. KISHWAUKEE CORPORATE HEALTH @MOI NPI is 1467841809. The provider is registered as an organization entity type.

The provider's business location address is:

2111 MIDLANDS CT
SUITE 201
SYCAMORE, IL
ZIP 60178-125
Phone: (181) 575-4488

The provider's authorized official is Patrick G Gannon .
The authorized official title is Physician and has the following contact phone number (815) 754-4882.

The enumeration date for this NPI number is 1/22/2015 and was last updated on 1/22/2015.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QX0100XClinic/CenterOccupational Medicine036-077643ILLINOISYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
11255594545OTHERILLINOISWORKER'S COMP

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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