Organization
NEW LIFE PENTECOSTAL MEDICAL CLINIC FOR THE UNINSURED INC
Active
Other names
New Life Pentecostal Medical Clinic for the Uninsured
Organization subpart
No
Provider details
NPI number
Authorized official
OMAR GARCIA M.D. (MEDICAL DIRECTOR)
(815) 304-4305
Entity
Organization
Contact information
Practice address
183 N SCHUYLER AVE, KANKAKEE, IL 60901-3828
(815) 304-4305
(815) 304-4306
Mailing address
183 N SCHUYLER AVE, KANKAKEE, IL 60901-3828
(815) 304-4305
(815) 304-4306
Taxonomy
Speciality
Code
Description
License number
State
2083X0100X
Occupational Medicine Physician
Primary
036.124389
IL
Other
Enumeration date
05/10/2011
Last updated
05/17/2012
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