Kanahi Beathea, CNA

Individual provider Active NPI Case Manager/Care Coordinator · East Dundee, IL

NPI 1124590328 · NPPES record last updated Dec 28, 2018

Key facts

NPI
1124590328
Entity type
Individual (NPI type 1)
Primary specialty
Case Manager/Care Coordinator 171M00000X
Practice address
455 E Main St
East Dundee, IL 60118-1529
Phone
(847) 428-2273
Fax
(847) 428-3128
NPI assigned
Dec 28, 2018
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X Yes

Addresses

Primary practice location

455 E Main St
East Dundee, IL 60118-1529

Mailing address

2200 S Main St Ste 309
Lombard, IL 60148-5366
Phone (847) 656-8288

Other providers in East Dundee, IL

All providers in East Dundee, IL · Case Manager/Care Coordinator in Illinois

Sources for this page

Verify at the official NPI Registry.