NPI 1609168657

New Life Pentecostal Medical Clinic for the Uninsured INC

Organisation Occupational Medicine Physician Kankakee, IL

Practice location

Address: 183 N Schuyler Ave, Kankakee, IL 60901-3828
Phone: (815) 304-4305
Fax: (815) 304-4306

Authorised official

Name: Omar Garcia
Title: Medical Director
Phone: (815) 304-4305

Registered specialties

Occupational Medicine Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 2083X0100X Licence 036.124389 (IL)

Other Preventive Medicine providers in Illinois →

Registry record

NPI: 1609168657
Entity type: Organization
NPI issued: 10 May 2011
Record last updated: 17 May 2012

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.