Organization
DIGESTIVE DISEASES CONSULTANTS OF KANKAKEE, SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CHRISTINA M O'CONNOR (ADMINISTRATOR)
(815) 602-8253
Entity
Organization
Contact information
Practice address
1615 N. CONVENT ST, STE 1, BOURBONNAIS, IL 60914
(815) 937-5200
(815) 937-2063
Mailing address
1615 N. CONVENT ST, STE 1, BOURBONNAIS, IL 60914
(815) 937-5200
(815) 937-2063
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1407966302
—
IL
Enumeration date
08/30/2006
Last updated
09/05/2024
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