Kankakee School District 111 School-Based Health Center
LBN: Kankakee School District 111 School-Based Health Center
Kankakee School District 111 School-Based Health Center is an health care organization with primary practice located at 2250 E Crestwood St , Kankakee IL 60901-2803. The organization recently has 2 registered licenses in different health care specialties including Dental Providers / General Practice, Ambulatory Health Care Facilities / Student Health. Ambulatory Health Care Facilities / Student Health is the primary health care specialty.
Kankakee School District 111 School-Based Health Center can be contacted via phone (815) 933-0772, or through Ali, Brian via phone (815) 933-0772.
Contact Information
Primary practice address
2250 E Crestwood St
Kankakee IL 60901-2803
Phone: (815) 933-0772
Fax: (815) 933-6730
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / General Practice | 1223G0001X | Illinois | |
| Ambulatory Health Care Facilities / Student Health | 261QS1000X | Illinois | |
| Ambulatory Health Care Facilities / Student Health | 261QS1000X | Illinois |
Profile Details
| NPI number | 1235256520 |
|---|---|
| LBN Legal business name | Kankakee School District 111 School-Based Health Center |
| DBA Doing business as | |
| Authorized official | Ali, Brian |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Mar 23rd, 2007 |
| Last updated | Apr 20th, 2008 - about 17 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1235256520 | NPPES |
| Illinois | MEDICAID | 336004784004 |
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