# PEDIATRIC WALK-IN, LLC

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

## Provider details

- **NPI number:** 1649642547
- **Authorized official:** DR. JOSEPH CANGAS MD (CEO)
- **Authorized official phone:** (618) 281-4325

## Contact information

- **Practice address:** 109 W LEGION AVE, COLUMBIA, IL 62236-2341
- **Practice address phone:** (618) 281-4325
- **Practice address fax:** (618) 208-1313
- **Mailing address:** 109 W LEGION AVE, COLUMBIA, IL 62236-2341

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QU0200X | Urgent Care Clinic/Center | 036110913 | IL | Yes |

## Other

- **Enumeration date:** 10/30/2015
- **Last updated:** 10/30/2015