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).
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 |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 261QX0100X |
Clinic/Center Specialization: Occupational Medicine |
036-077643 | IL | Ambulatory Health Care Facilities |
State | Issuer | Identifier | Type Code |
---|---|---|---|
IL | WORKER'S COMP | 1255594545 | 01 |
Street Address |
2111 MIDLANDS CT SUITE 201 |
City | SYCAMORE |
State | IL |
Zip Code | 60178-3125 |
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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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 |
Find all providers in zip 60178 |
Taxonomy Code | 261QX0100X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
Specialization | Occupational Medicine |
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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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.