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Organization
NOVUS ILLINOIS SERVICE CORPORATION
Active
Organization
NOVUS ILLINOIS SERVICE CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOSHUA POOLE (PRESIDENT)
(404) 285-8388
Entity
Organization
Contact information
Practice address
350 N WALL ST, KANKAKEE, IL 60901-2901
(159) 357-2568
Mailing address
PO BOX 12766, PENSACOLA, FL 32591-2766
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
NULL
207L00000X
Anesthesiology Physician
Primary
—
—
367500000X
Certified Registered Nurse Anesthetist
—
NULL
367500000X
Certified Registered Nurse Anesthetist
—
—
Other
Enumeration date
11/09/2021
Last updated
10/17/2026
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