| |
10012 W 190th Pl Bldg A, Mokena, IL 60448-8752 | |
(708) 478-0690 | |
(708) 400-7949 |
Full Name | |
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Type | Facility |
Speciality | Clinic/center - Medical Specialty |
Location | 10012 W 190th Pl Bldg A, Mokena, Illinois |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
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1073757811 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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111N00000X | Chiropractor | 038-007483 (Illinois) | Secondary |
261QM2500X | Clinic/center - Medical Specialty | (* (Not Available)) | Primary |
Provider Name | Stephen R Beyer |
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Provider Type | Practitioner - Chiropractic |
Provider Identifiers | NPI Number: 1922293968 PECOS PAC ID: 3375576499 Enrollment ID: I20090820000430 |
Provider Name | Jennifer N Van Kempen |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1487140380 PECOS PAC ID: 8729332424 Enrollment ID: I20181115002397 |
Provider Name | Kelli L Harkey |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1396283495 PECOS PAC ID: 1658640727 Enrollment ID: I20200331001402 |
Mailing Address | Practice Location Address |
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10012 W 190th Pl, Mokena, IL 60448-8752 Ph: (708) 478-0690 | 10012 W 190th Pl Bldg A, Mokena, IL 60448-8752 Ph: (708) 478-0690 |