Med Peds Associates

LBN: Med Peds Associates
Med Peds Associates is an health care organization with primary practice located at 375 N Wall St Ste P520 , Kankakee IL 60901-3493. The organization recently has only one registered license in Suppliers / Non-Pharmacy Dispensing Site, which is considered as the primary health care specialty. Med Peds Associates can be contacted via phone (815) 933-0194, or through Shackelford, Direndia via phone (800) 654-0889.

Contact Information

Primary practice address
375 N Wall St Ste P520 Kankakee IL 60901-3493
Phone: (815) 933-0194
Fax: (815) 933-1444
Website:
Map and Directions
Authorized official contact:
Name: Shackelford, Direndia
Phone: (800) 654-0889

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Non-Pharmacy Dispensing Site 332900000X 036074737 Illinois

Profile Details

NPI number 1649353970
LBN Legal business name Med Peds Associates
DBA Doing business as Med Peds Associates
Authorized official Shackelford, Direndia
Entity Organization
Organization subpart 1 No
Enumeration date Oct 23rd, 2006
Last updated Sep 3rd, 2008 - about 16 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1649353970 NPPES
Other 1472505 OTHER ID NUMBER-COMMERCIAL NUMBER
MEDICAID 036074737 OTHER ID NUMBER-COMMERCIAL NUMBER

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