MOKENA FAMILY PHYSICIANS LLC NPI 1740359876

NPI Information

  • NPI: 1740359876
  • Provider Name: MOKENA FAMILY PHYSICIANS LLC
  • Classification: Clinic/Center - 261Q00000X
  • Entity Type: Organization
  • Address: 11243 W LA PORTE RD
    MOKENA, IL
    ZIP 60448
  • Phone: (708) 479-4681

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NPI Details

MOKENA FAMILY PHYSICIANS LLC is a clinic center in Mokena, IL. The provider is a facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). MOKENA FAMILY PHYSICIANS LLC NPI is 1740359876. The provider is registered as an organization entity type.

The provider's business location address is:

11243 W LA PORTE RD
MOKENA, IL
ZIP 60448-374
Phone: (708) 479-4681
Fax: (708) 479-8516

The provider's authorized official is Rhonda A Davis .
The authorized official title is Manager and has the following contact phone number (708) 479-4681.

The enumeration date for this NPI number is 11/6/2006 and was last updated on 6/25/2013.

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
1261Q00000XClinic/Center036085722ILLINOISYes

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
1C44500MEDICARE UPINILLINOIS
2F31981MEDICARE UPINILLINOIS
3K01489MEDICARE ID-TYPE UNSPECIFIEDILLINOIS
4036085722MEDICAIDILLINOIS
5036077425MEDICAIDILLINOIS
6K01488MEDICARE ID-TYPE UNSPECIFIEDILLINOIS

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: 3/30/2025

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