KISHWAUKEE CORPORATE HEALTH @MOI


Address: 2111 Midlands Ct, Suite 201, Sycamore, IL 60178-3125
Phone: 1815754488

KISHWAUKEE CORPORATE HEALTH @MOI (NPI# 1467841809) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1467841809
Entity Type Organization
Organization Name KISHWAUKEE CORPORATE HEALTH @MOI
Practice Address 2111 Midlands Ct
Suite 201
Sycamore
IL 60178-3125
Mailing Address 2111 Midlands Ct
Suite 201
Sycamore
IL 60178
Practice Telephone 1815754488
Mailing Telephone 1815754488
Enumeration Date 2015-01-22
Last Update Date 2015-01-22
Authorized Official Name DR. PATRICK G GANNON (PHYSICIAN)
Authorized Official Telephone 8157544882
Authorized Official Credential DO
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 261QX0100X Clinic/Center
Specialization: Occupational Medicine
036-077643 IL Ambulatory Health Care Facilities

Other Provider Identifier

State Issuer Identifier Type Code
IL WORKER'S COMP 1255594545 01

Office Location

Street Address 2111 MIDLANDS CT
SUITE 201
City SYCAMORE
State IL
Zip Code 60178-3125

Providers in the same location

NPI Name Taxonomy Address Enumeration
1669444709 Ibrahim S Alghafeer Internal Medicine 2111 Midlands Ct, Sycamore, IL 60178-3125 2006-02-03
1366003071 Ciara Lightner Occupational Therapist 2111 Midlands Ct, Sycamore, IL 60178-3125 2019-06-24
1205344215 Matthew Kraft Specialist/Technologist 2111 Midlands Ct, Sycamore, IL 60178-3125 2018-01-12
1174076814 Allison Bucaro-fink Physical Therapy Assistant 2111 Midlands Ct, Sycamore, IL 60178-3125 2016-07-29
1861840597 Stephanie Rae Liesse Physical Therapist 2111 Midlands Ct, Sycamore, IL 60178-3125 2016-06-03
1437524626 Stacie Marie Lee Physician Assistant 2111 Midlands Ct, Sycamore, IL 60178-3125 2015-12-14
1396161576 Sarah Carlson Specialist 2111 Midlands Ct, Sycamore, IL 60178-3125 2014-03-11
1386980308 Taylor Sweers Physical Therapist 2111 Midlands Ct, Sycamore, IL 60178-3125 2012-12-19
1679801674 David Gramer Specialist/Technologist 2111 Midlands Ct, Sycamore, IL 60178-3125 2009-12-02
1811225261 Susan K Mueller Nurse Practitioner 2111 Midlands Ct, Sycamore, IL 60178-3125 2009-11-23
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1578113387 Susanne Dewey Technician 2158 W. Vance St., Sycamore, IL 60178 2019-09-13
1730745332 Nan Chinratana Phillips Registered Nurse 427 Spartan Trail Shs Nurse Office, Sycamore, IL 60178 2019-05-20
1427517846 Association for Individual Development Clinic/Center 180 E. Exchange St., #202a, Sycamore, IL 60178 2019-03-15
1528508884 Mary Elizabeth Kelley Counselor 920 S Prairie Dr., F, Sycamore, IL 60178 2017-03-06
1366824005 Dekalb Hearing Services, LLC Audiologist 1630 Gateway Drive, Sycamore, IL 60178 2015-06-18
1629458625 Friedrichs Eye Ltd. Ophthalmology 2670 Dekalb Avenue, Sycamore, IL 60178 2015-06-04
1275912057 Sara Haug Counselor 324 E. Exchange St, Sycamore, IL 60178 2015-05-26
1144607862 Dekalb Surgical Services, LLC Clinic/Center 2515 Klein Road, Sycamore, IL 60178 2015-05-01
1720476963 Jennifer Calderala Registered Nurse 165 E. Plank Road, Sycamore, IL 60178 2014-12-22
1114262656 Teresa Kay Farris Nurse Practitioner 1850 Gateway Drive, Sycamore, IL 60178 2012-12-11
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Taxonomy Information

Taxonomy Code 261QX0100X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization Occupational Medicine

Taxonomy Definition

Definition to come...

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1154871127 Concentra Clinic/Center 7421 South Cass Avenue, Darien, IL 60561-3607 2016-10-13
1679927222 Child Therapy and Rehabilitation LLC Clinic/Center 790 Fletcher Dr, Unit 101, Elgin, IL 60123-4755 2016-04-20
1356715684 Indus Medicine Ltd Clinic/Center 739 Hoover Dr, Carol Stream, IL 60188-1590 2015-11-24
1598131393 Functional Life Consulting, LLC Clinic/Center 813 Seward St, Unit 3s, Evanston, IL 60202-2882 2015-08-15
1427488899 Let's Grow, Inc. Clinic/Center 1746 W 17th St Rear, Chicago, IL 60608 2013-11-20
1447592704 Occupational Health Centers of Illinois PC Clinic/Center 7421 S Cass Ave, Darien, IL 60561-3607 2013-03-25
1518204650 Healthworks Medical Group of Illinois S C Clinic/Center 11601 W Touhy Ave, O'hare International Airport- Terminal 2- Lower Level, Chicago, IL 60666-5047 2013-01-09
1427366921 Healthworks Medical Group of Illinois S C Clinic/Center 5100 Lake Terrance Ne, Mount Vernon, IL 62864-9665 2010-09-17
1932426285 Medworks Joliet Corp Clinic/Center 815 Campus Drive, Joliet, IL 60435 2010-04-27
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Competitor

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City SYCAMORE
Zip Code 60178

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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