Kishwaukee Corporate Health

Primary specialty

Corporate Health Clinic/CenterTaxonomy code 261QC1800X

License

036-077643 Issued in IL

Legal business name

KISHWAUKEE CORPORATE HEALTH

Practice address

3251 Commerce Dr Ste B
Dekalb, IL 60115-7908

Phone

(815) 754-4882

NPI assigned

Jul 7, 2008

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Patrick G Gannon, D.O.

Title

Medical Director

Phone

(815) 754-4882

Specialties & licenses 1

Addresses

Tax ID family

Kishwaukee Corporate Health2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Kishwaukee Corporate Health @Moi

  • Occupational Medicine Clinic/Center
  • Sycamore, IL
  • NPI 1467841809
  NPD tax ID

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1215388800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1215388800000",
    "number": "1255594545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3251 COMMERCE DR STE B",
            "city": "DEKALB",
            "state": "IL",
            "postal_code": "601157908",
            "telephone_number": "815-754-4882"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3251 COMMERCE DR STE B",
            "city": "DEKALB",
            "state": "IL",
            "postal_code": "601157908",
            "telephone_number": "815-754-4882"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KISHWAUKEE CORPORATE HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-07",
        "last_updated": "2008-07-07",
        "status": "A",
        "authorized_official_last_name": "GANNON",
        "authorized_official_first_name": "PATRICK",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "815-754-4882",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "261QC1800X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Corporate Health",
            "state": "IL",
            "license": "036-077643",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kishhealth System
• Kishwaukee Community Health Services Center
• Kishwaukee Community Hospital
• Kishwaukee Community Hospital
• Kishwaukee Community Hospital
• Kishwaukee Dental Associates, LTD.
• Kishwaukee Physician Group Inc
• Bethany Marie Kisner-Crosby, MA-SLP-CCC-L
• Blythe H Kitner, AU.D.
• Daniel Klein, LCSW

• Corporate Health Clinic/Center in Dekalb, IL
• Providers in Dekalb, IL by specialty
• Corporate Health Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.