institution
K C A S Ent Inc.
Pediatric Nurse Practitioner in Marengo, Illinois
NPI 1659373132

K C A S Ent Inc. is a Pediatric Nurse Practitioner based in Marengo, IL and is specialized in Pediatrics. K C A S Ent Inc. practices in Marengo, IL. The NPI Number for K C A S Ent Inc. is 1659373132 and holds a License No. 209000890 (Illinois).

The current practice location address for K C A S Ent Inc. is 706 N Taylor St, Marengo, IL and can be reached out via phone at 815-568-0243 and via fax at 815-568-5350.

Location: 706 N Taylor St, Marengo, IL, 60152-2457
institution
Provider Profile Details
NPI Number
1659373132
Provider Name
K C A S Ent Inc.
Credential
Provider Entity Type
Organization
Address
706 N Taylor St, Marengo, IL, 60152-2457
Phone Number
815-568-0243
Fax Number
815-568-5350
Provider Enumeration Date
08/13/2005
Last Update Date
03/08/2024
tick
Provider's Legacy Identifiers
Identifier Type State Issuer
341407830001 05 IL
institution
Provider Business Practice Location Address Details
Address
706 N Taylor St
City
State
Zip
60152-2457
Phone Number
815-568-0243
Fax Number
815-568-5350
person
Provider Business Mailing Address Details
Address
706 N Taylor St
City
State
Zip
60152-2457
Phone Number
815-568-0243
Fax Number
815-568-5350
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Pediatrics
Taxonomy
License No.
209000890 (Illinois)
Definition
Definition to come...
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