NPI 1144929167

Kaleb Church, PA

Practitioner Physician Assistant Geneva, IL

Practice location

Address: 2535 Soderquist CT, Geneva, IL 60134-0020
Phone: (630) 584-1400
Fax: (630) 584-1733
Mailing address: 2525 Kaneville Rd, Geneva, IL 60134-2578

Registered specialties

Physician Assistant Primary

Physician Assistants & Advanced Practice Nursing Providers Taxonomy 363A00000X Licence 085009365 (IL)

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Registry record

NPI: 1144929167
Entity type: Individual
Sex (as registered): Male
NPI issued: 28 Feb 2023
Record last updated: 28 Feb 2023

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.