# APOLLO MEDICAL GROUP OF KANKAKEE LLC

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

## Provider details

- **NPI number:** 1710418934
- **Authorized official:** DR. AYMAN ELFAR MD (MEMBER/MANAGER)
- **Authorized official phone:** (812) 455-7798

## Contact information

- **Practice address:** 403 S KENNEDY DR, BRADLEY, IL 60915-2152
- **Practice address phone:** (815) 928-9999
- **Practice address fax:** (815) 928-9916
- **Mailing address:** PO BOX 1963, INDIANAPOLIS, IN 46206-1963
- **Mailing address phone:** (941) 360-1566
- **Mailing address fax:** (941) 358-9818

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207L00000X | Anesthesiology Physician | — | NULL | Yes |
| 207L00000X | Anesthesiology Physician | — | — | Yes |

## Other

- **Enumeration date:** 03/21/2017
- **Last updated:** 03/21/2017