| Kishwaukee Medical Associates | |
|
954 West State Street Sycamore IL 60118 | |
| (815) 895-9144 | |
| (815) 899-4234 |
| Full Name | Kishwaukee Medical Associates |
|---|---|
| Speciality | Family Medicine |
| Location | 954 West State Street, Sycamore, Illinois |
| Authorized Official Name and Position | John E Klosowski (ADMINISTRATOR) |
| Authorized Official Contact | 8158959144 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kishwaukee Medical Associates 954 West State Street Sycamore IL 60118 Ph: (815) 895-9144 | Kishwaukee Medical Associates 954 West State Street Sycamore IL 60118 Ph: (815) 895-9144 |
| NPI Number | 1871718551 |
|---|---|
| Provider Enumeration Date | 04/16/2007 |
| Last Update Date | 02/22/2008 |
| Medicare PECOS PAC ID | 9537156179 |
|---|---|
| Medicare Enrollment ID | O20040427000790 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871718551 | NPI | - | NPPES |
| Provider Name | Michael William Thornton |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1699703405 PECOS PAC ID: 2860517653 Enrollment ID: I20100916001007 |
| Provider Name | Mark A Drendel |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1639128358 PECOS PAC ID: 4789876798 Enrollment ID: I20101008000831 |
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