Organization
HEDGES CLINIC SERVICE CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. FRANK JOSEPH SCHIBLI CMPE (ADMINISTRATOR)
(815) 469-2123
Entity
Organization
Contact information
Practice address
21205 OWENS RD STE 3, MOKENA, IL 60448-2023
(815) 469-2123
(815) 469-2149
Mailing address
21205 OWENS RD STE 3, MOKENA, IL 60448-2023
(815) 469-2123
(815) 469-2149
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
—
208000000X
Pediatrics Physician
—
—
208600000X
Surgery Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
09915014
BLUE CROSS BLUE SHIELD
IL
Enumeration date
11/16/2006
Last updated
03/01/2022
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