Kankakee Family Medicine

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

KANKAKEE FAMILY MEDICINE

Practice address

400 North Wall St
Ste 504
Kankakee, IL 60901-2965

Phone

(815) 932-4021

Fax

(815) 932-7270

NPI assigned

Aug 31, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Kenneth George Handy, MD

Title

Partner

Phone

(815) 932-4021

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1508977513",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 NORTH WALL ST",
            "address_2": "STE 504",
            "city": "KANKAKEE",
            "state": "IL",
            "postal_code": "609012965",
            "telephone_number": "815-932-4021",
            "fax_number": "815-932-7270"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 NORTH WALL ST",
            "address_2": "STE 504",
            "city": "KANKAKEE",
            "state": "IL",
            "postal_code": "609012965",
            "telephone_number": "815-932-4021",
            "fax_number": "815-932-7270"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KANKAKEE FAMILY MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-31",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HANDY",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "GEORGE",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "815-932-4021",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Kankakee School District 111

• All providers in Kankakee, IL
• Family Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.