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Organization

GENERAL SURGEONS OF KANKAKEE LTD

Active
Organization subpart
No

Provider details

NPI number
Authorized official
PAUL ROWLAND MD (PRESIDENT)
(815) 932-0911
Entity
Organization

Contact information

Practice address
375 N WALL ST, SUITE P640, KANKAKEE, IL 60901-3483
(815) 932-0911
(815) 932-0631
Mailing address
777 OAKMONT LN, SUITE 1600, WESTMONT, IL 60559-5511
(630) 789-2550

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
123451234567
HEALTHLINK INC PPO ID
IL
01
4615036
BCBS PROVIDER ID
IL
01
CF2109
RAILROAD MEDICARE
IL
Enumeration date
06/21/2006
Last updated
01/29/2008
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