Individual
DR. KEVIN CHACKO VARGHESE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
350 N WALL ST, KANKAKEE, IL 60901-2901
(815) 933-1671
(815) 933-0662
Mailing address
400 S KENNEDY DR STE 300, BRADLEY, IL 60915-2682
(815) 937-1237
(815) 933-0662
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
036171273
IL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/30/2020
Last updated
10/02/2024
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