# NOVUS ILLINOIS SERVICE CORPORATION

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1295491744
- **Authorized official:** MR. JOSHUA POOLE (PRESIDENT)
- **Authorized official phone:** (404) 285-8388

## Contact information

- **Practice address:** 350 N WALL ST, KANKAKEE, IL 60901-2901
- **Practice address phone:** (159) 357-2568
- **Mailing address:** PO BOX 12766, PENSACOLA, FL 32591-2766

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207L00000X | Anesthesiology Physician | — | NULL | Yes |
| 207L00000X | Anesthesiology Physician | — | — | Yes |
| 367500000X | Certified Registered Nurse Anesthetist | — | NULL | — |
| 367500000X | Certified Registered Nurse Anesthetist | — | — | — |

## Other

- **Enumeration date:** 11/09/2021
- **Last updated:** 10/17/2026