# KANKAKEE INTERNAL MEDICINE GROUP

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

## Provider details

- **NPI number:** 1942450366
- **Authorized official:** DR. SUNIL K SHAH (PRESIDENT)
- **Authorized official phone:** (630) 952-1412

## Contact information

- **Practice address:** 7641 NEWFIELD LN, TINLEY PARK, IL 60487-5539
- **Practice address phone:** (630) 952-1412
- **Practice address fax:** (630) 952-1447
- **Mailing address:** 7641 NEWFIELD LN, TINLEY PARK, IL 60487-5539
- **Mailing address phone:** (630) 952-1412
- **Mailing address fax:** (630) 952-1447

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | 0361058 | IL | Yes |

## Other

- **Enumeration date:** 09/22/2008
- **Last updated:** 09/22/2008