| Aunt Marthas Kankakee Community Health Center | |
|
1777 E Court St Kankakee IL 60901-2670 | |
| (708) 747-7100 | |
| Not Available |
| Full Name | Aunt Marthas Kankakee Community Health Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 1777 E Court St, Kankakee, Illinois |
| Authorized Official Name and Position | Christopher J Nordloh (CFO) |
| Authorized Official Contact | 7087477100 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Aunt Marthas Kankakee Community Health Center 19990 Governors Hwy Olympia Fields IL 60461-1021 Ph: (708) 747-7100 | Aunt Marthas Kankakee Community Health Center 1777 E Court St Kankakee IL 60901-2670 Ph: (708) 747-7100 |
| NPI Number | 1790825347 |
|---|---|
| Provider Enumeration Date | 02/06/2007 |
| Last Update Date | 07/21/2022 |
| Medicare PECOS PAC ID | 7214846922 |
|---|---|
| Medicare Enrollment ID | O20090710000496 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790825347 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | 033 (Illinois) | Primary |
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